Quality Measure Implementation Guide (STU5)
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Quality Measure Implementation Guide (STU5), published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ballot2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

Resource Profile: CQFMPublishableManifest - Detailed Descriptions

Active as of 2024-03-15

Definitions for the publishable-manifest-cqfm resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Library
2. Library.useContext
Must Supporttrue
SlicingThis element introduces a set of slices on Library.useContext. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ code
  • 4. Library.useContext:qualityProgram
    Slice NamequalityProgram
    Definition

    Supporting the definition of Quality Pograms.

    Control0..1
    Must Supporttrue
    6. Library.useContext:qualityProgram.code
    Control1..1
    TypeCoding
    Must Supporttrue
    Pattern Value{
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "program"
    }
    8. Library.useContext:qualityProgram.value[x]
    Definition

    Support the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs.

    Control1..1
    BindingFor example codes, see Quality Programs Example
    (example to http://hl7.org/fhir/us/cqfmeasures/ValueSet/quality-programs-example)

    Supports the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs

    TypeCodeableConcept
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. Library
    Definition

    Represents an artifact manifest, specifying version-specific dependencies of an artifact or group of artifacts. Artifact manifests are used throughout the content development lifecycle to establish version bindings for unversioned canonical references. Prior to release (when the status is draft) of the artifact(s), the manifest establishes the expansion rules such as code system versions used for expansion of value sets while artifacts are being authored. As part of release, the manifest is used to provide a complete dependency listing, as well as complete binding for all unversioned dependencies referenced in the artifacts so that canonical references can be reliably resolved, ensuring the stability of value set expansions used for evaluation of the artifacts.


    The Library resource is a general-purpose container for knowledge asset definitions. It can be used to describe and expose existing knowledge assets such as logic libraries and information model descriptions, as well as to describe a collection of knowledge assets.

    ShortRepresents a library of quality improvement components
    Comments

    Prior to release, artifact(s) should specify code system versions to support stable expansion of value sets during the development phase (also called an expansion profile). Post release, the artifact(s) may specify expansion identifiers to lock the code lists used for value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest).

    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    lib-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
    lib-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
    2. Library.implicitRules
    Definition

    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.

    ShortA set of rules under which this content was created
    Comments

    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.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Library.extension:directReferenceCode
    Slice NamedirectReferenceCode
    Definition

    Defines a code directly referenced by artifact logic, as opposed to a value set. Direct reference codes may be the target of data requirements.

    ShortA code directly referenced by the artifact
    Control0..*
    TypeExtension(Direct reference code) (Extension Type: Coding)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    6. Library.extension:logicDefinition
    Slice NamelogicDefinition
    Definition

    Represents a specific logic definition used by the artifact.

    ShortA logic definition used in the artifact
    Control0..*
    TypeExtension(Logic definition) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Requirements

    A manifest library must be able to describe the logic definitions it uses.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Library.extension:cqlOptions
    Slice NamecqlOptions
    Definition

    Specifies a parameters (contained) resource that identifies the options for the CQL-to-ELM translator associated with the CQL content.

    ShortWhat options
    Comments

    When this extension is used with a specific CQL library, it indicates the options that are to be used to translate the CQL to ELM. ELM Libraries carry the options they were translated with, so this does not need to be specified. If the options are not specified, the translation options identified here are used.

    Control0..1
    TypeExtension(CQF CQL Options) (Extension Type: Reference(Parameters))
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Library.extension:expansionParameters
    Slice NameexpansionParameters
    Definition

    Specifies the expansion parameters that should be used to expand the ValueSet, or any ValueSets in the Library (or referenced by components of the Library).

    ShortWhat expansion rules
    Comments

    For a complete description of how these expansion rules impact the behavior of the expansion operation, see the Expansion Rules topic.

    Control0..1
    TypeExtension(Expansion Parameters) (Extension Type: Reference(Parameters))
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Library.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    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.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Library.status
    Definition

    The status of this library. Enables tracking the life-cycle of the content.

    Shortdraft | active | retired | unknown
    Comments

    Allows filtering of libraries that are appropriate for use vs. not.

    Control1..1
    BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

    The lifecycle status of an artifact.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Library.type
    Definition

    Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition.

    Shortlogic-library | model-definition | asset-collection | module-definition
    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from LibraryTypehttp://hl7.org/fhir/ValueSet/library-type
    (extensible to http://hl7.org/fhir/ValueSet/library-type)

    The type of knowledge asset this library contains.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/library-type",
        "code" : "asset-collection"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Library.useContext
    Definition

    The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate library instances.

    ShortThe context that the content is intended to support
    Comments

    When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

    Control0..*
    TypeUsageContext
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Assist in searching for appropriate content.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Library.useContext. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ code
    • 20. Library.useContext:qualityProgram
      Slice NamequalityProgram
      Definition

      Supporting the definition of Quality Pograms.


      The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate library instances.

      ShortThe context that the content is intended to support
      Comments

      When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

      Control0..1*
      TypeUsageContext
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Assist in searching for appropriate content.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Library.useContext:qualityProgram.code
      Definition

      A code that identifies the type of context being specified by this usage context.

      ShortType of context being specified
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from UsageContextTypehttp://hl7.org/fhir/ValueSet/usage-context-type
      (extensible to http://hl7.org/fhir/ValueSet/usage-context-type)

      A code that specifies a type of context being specified by a usage context.

      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "program"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Library.useContext:qualityProgram.value[x]
      Definition

      Support the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs.


      A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

      ShortValue that defines the context
      Control1..1
      BindingFor example codes, see Quality Programs Examplehttp://hl7.org/fhir/ValueSet/use-context
      (example to http://hl7.org/fhir/us/cqfmeasures/ValueSet/quality-programs-example)

      Supports the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs


      A code that defines the specific value for the context being specified.

      TypeCodeableConcept, Reference(PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Library.relatedArtifact
      Definition

      Related artifacts such as additional documentation, justification, or bibliographic references.

      ShortAdditional documentation, citations, etc.
      Comments

      Each related artifact is either an attachment, or a reference to another resource, but not both.

      Control0..*
      TypeRelatedArtifact
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Library.relatedArtifact. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ type
      • 28. Library.relatedArtifact:component
        Slice Namecomponent
        Definition

        A canonical resource (such as a Library, CodeSystem, or ValueSet) that is part of the manifest.


        Related artifacts such as additional documentation, justification, or bibliographic references.

        ShortWhat components are in the manifestAdditional documentation, citations, etc.
        Comments

        This is the full list of component artifacts. Each component may be either a specific artifact (such as a Library, ValueSet, or Measure), or it may itself be an artifact manifest (i.e. a Library conforming to this profile) to allow manifest information (dependency version binding) to be specified per artifact, rather than requiring it all to be specified at the root level of the manifest).


        Each related artifact is either an attachment, or a reference to another resource, but not both.

        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Manifests must be able to unambiguously specify the set of components that make up the artifact collection. The version of each component SHALL be included in the canonical reference to the component.


        Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        mnf-1: Component reference must be either a resourceReference (referencing a canonical promotion) or a canonical (referencing a canonical resource), but not both (resource.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-RelatedArtifact.resourceReference').exists())
        30. Library.relatedArtifact:component.extension:isOwned
        Slice NameisOwned
        Definition

        To provide an indication of whether or not a referenced artifact is owned in context of the referencing artifact and therefore if it's lifecycle is managed in that context.

        ShortWhether or not the referenced artifact is owned by the referencing artifact.
        Control0..1
        TypeExtension(Artifact Is Owned) (Extension Type: boolean)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. Library.relatedArtifact:component.extension:resourceReference
        Slice NameresourceReference
        Definition

        A reference to a canonical promotion of a FHIR resource (i.e. a non-canonical resource that has been promoted to a canonical resource so it can be used in definitional contexts).

        ShortA reference to the component artifact (for canonical promotions)
        Control0..1
        This element is affected by the following invariants: mnf-1
        TypeExtension(Extension Definition for RelatedArtifact.resourceReference for Version 5.0) (Extension Type: Reference(Resource))
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        34. Library.relatedArtifact:component.type
        Definition

        The type of relationship to the related artifact.

        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
        Control1..1
        BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

        The type of relationship to the related artifact.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Fixed Valuecomposed-of
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Library.relatedArtifact:component.display
        Definition

        A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

        ShortBrief description of the related artifact
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Library.relatedArtifact:component.resource
        Definition

        The related resource, such as a library, value set, profile, or other knowledge resource.

        ShortA reference to the component artifact (for canonical resources)What resource is being referenced
        Comments

        If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

        Control0..1
        This element is affected by the following invariants: mnf-1
        Typecanonical(Resource)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Library.relatedArtifact:dependency
        Slice Namedependency
        Definition

        A canonical resource (such as a Library, CodeSystem, or ValueSet) referenced by any artifact in the release, or any dependency of any artifact in the release, recursively.


        Related artifacts such as additional documentation, justification, or bibliographic references.

        ShortWhat dependencies are referencedAdditional documentation, citations, etc.
        Comments

        This is the full list of dependencies of all artifacts used in the specification.


        Each related artifact is either an attachment, or a reference to another resource, but not both.

        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Artifacts must be able to unambiguously specify the versions of all dependencies used by artifacts in a specification. The version of each dependency SHALL be included in the canonical reference to the dependency.


        Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        mnf-2: Dependency reference must be either a resourceReference (referencing a canonical promotion) or a canonical (referencing a canonical resource), but not both (resource.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-RelatedArtifact.resourceReference').exists())
        42. Library.relatedArtifact:dependency.extension:resourceReference
        Slice NameresourceReference
        Definition

        A reference to a canonical promotion of a FHIR resource (i.e. a non-canonical resource that has been promoted to a canonical resource so it can be used in definitional contexts).

        ShortA reference to the dependency artifact (for canonical promotions)
        Control0..1
        This element is affected by the following invariants: mnf-2
        TypeExtension(Extension Definition for RelatedArtifact.resourceReference for Version 5.0) (Extension Type: Reference(Resource))
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        44. Library.relatedArtifact:dependency.type
        Definition

        The type of relationship to the related artifact.

        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
        Control1..1
        BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

        The type of relationship to the related artifact.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Fixed Valuedepends-on
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Library.relatedArtifact:dependency.display
        Definition

        A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

        ShortBrief description of the related artifact
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Library.relatedArtifact:dependency.resource
        Definition

        The related resource, such as a library, value set, profile, or other knowledge resource.

        ShortA reference to the dependency artifact (for canonical resources)What resource is being referenced
        Comments

        If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

        Control0..1
        This element is affected by the following invariants: mnf-2
        Typecanonical(Resource)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Library.content
        Definition

        The content of the library as an Attachment. The content may be a reference to a url, or may be directly embedded as a base-64 string. Either way, the contentType of the attachment determines how to interpret the content.

        ShortContents of the library, either embedded or referenced
        Control0..0*
        TypeAttachment
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

        Guidance on how to interpret the contents of this table can be found here

        0. Library
        Definition

        Represents an artifact manifest, specifying version-specific dependencies of an artifact or group of artifacts. Artifact manifests are used throughout the content development lifecycle to establish version bindings for unversioned canonical references. Prior to release (when the status is draft) of the artifact(s), the manifest establishes the expansion rules such as code system versions used for expansion of value sets while artifacts are being authored. As part of release, the manifest is used to provide a complete dependency listing, as well as complete binding for all unversioned dependencies referenced in the artifacts so that canonical references can be reliably resolved, ensuring the stability of value set expansions used for evaluation of the artifacts.

        ShortRepresents a library of quality improvement components
        Comments

        Prior to release, artifact(s) should specify code system versions to support stable expansion of value sets during the development phase (also called an expansion profile). Post release, the artifact(s) may specify expansion identifiers to lock the code lists used for value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest).

        Control0..*
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        lib-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
        2. Library.id
        Definition

        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

        ShortLogical id of this artifact
        Comments

        The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

        Control0..1
        Typeid
        Is Modifierfalse
        Summarytrue
        4. Library.meta
        Definition

        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.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Library.implicitRules
        Definition

        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.

        ShortA set of rules under which this content was created
        Comments

        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.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. Library.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        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).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. Library.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortText summary of the resource, for human interpretation
        Comments

        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.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Library.contained
        Definition

        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.

        ShortContained, inline Resources
        Comments

        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.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        14. Library.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Library.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. Library.extension:directReferenceCode
          Slice NamedirectReferenceCode
          Definition

          Defines a code directly referenced by artifact logic, as opposed to a value set. Direct reference codes may be the target of data requirements.

          ShortA code directly referenced by the artifact
          Control0..*
          TypeExtension(Direct reference code) (Extension Type: Coding)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. Library.extension:logicDefinition
          Slice NamelogicDefinition
          Definition

          Represents a specific logic definition used by the artifact.

          ShortA logic definition used in the artifact
          Control0..*
          TypeExtension(Logic definition) (Complex Extension)
          Is Modifierfalse
          Must Supporttrue
          Requirements

          A manifest library must be able to describe the logic definitions it uses.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          20. Library.extension:cqlOptions
          Slice NamecqlOptions
          Definition

          Specifies a parameters (contained) resource that identifies the options for the CQL-to-ELM translator associated with the CQL content.

          ShortWhat options
          Comments

          When this extension is used with a specific CQL library, it indicates the options that are to be used to translate the CQL to ELM. ELM Libraries carry the options they were translated with, so this does not need to be specified. If the options are not specified, the translation options identified here are used.

          Control0..1
          TypeExtension(CQF CQL Options) (Extension Type: Reference(Parameters))
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          22. Library.extension:expansionParameters
          Slice NameexpansionParameters
          Definition

          Specifies the expansion parameters that should be used to expand the ValueSet, or any ValueSets in the Library (or referenced by components of the Library).

          ShortWhat expansion rules
          Comments

          For a complete description of how these expansion rules impact the behavior of the expansion operation, see the Expansion Rules topic.

          Control0..1
          TypeExtension(Expansion Parameters) (Extension Type: Reference(Parameters))
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          24. Library.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          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.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          26. Library.url
          Definition

          An absolute URI that is used to identify this library when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this library is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the library is stored on different servers.

          ShortCanonical identifier for this library, represented as a URI (globally unique)
          Comments

          Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

          The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

          In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

          Control0..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the library to be referenced by a single globally unique identifier.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Library.identifier
          Definition

          A formal identifier that is used to identify this library when it is represented in other formats, or referenced in a specification, model, design or an instance. e.g. CMS or NQF identifiers for a measure artifact. Note that at least one identifier is required for non-experimental active artifacts.

          ShortAdditional identifier for the library
          Comments

          Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this library outside of FHIR, where it is not possible to use the logical URI.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows externally provided and/or usable business identifiers to be easily associated with the module.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Library.version
          Definition

          The identifier that is used to identify this version of the library when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the library author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

          ShortBusiness version of the library
          Comments

          There may be different library instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the library with the format [url]|[version].

          NoteThis is a business versionId, not a resource version id (see discussion)
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Library.name
          Definition

          A natural language name identifying the library. This name should be usable as an identifier for the module by machine processing applications such as code generation.

          ShortName for this library (computer friendly)
          Comments

          The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

          Control0..1
          This element is affected by the following invariants: inv-0
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Support human navigation and code generation.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Library.title
          Definition

          A short, descriptive, user-friendly title for the library.

          ShortName for this library (human friendly)
          Comments

          This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Library.subtitle
          Definition

          An explanatory or alternate title for the library giving additional information about its content.

          ShortSubordinate title of the library
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Library.status
          Definition

          The status of this library. Enables tracking the life-cycle of the content.

          Shortdraft | active | retired | unknown
          Comments

          Allows filtering of libraries that are appropriate for use vs. not.

          Control1..1
          BindingThe codes SHALL be taken from PublicationStatus
          (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

          The lifecycle status of an artifact.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Library.experimental
          Definition

          A Boolean value to indicate that this library is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

          ShortFor testing purposes, not real usage
          Comments

          Allows filtering of librarys that are appropriate for use versus not.

          Control0..1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Enables experimental content to be developed following the same lifecycle that would be used for a production-level library.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Library.type
          Definition

          Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition.

          Shortlogic-library | model-definition | asset-collection | module-definition
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from LibraryType
          (extensible to http://hl7.org/fhir/ValueSet/library-type)

          The type of knowledge asset this library contains.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Pattern Value{
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/library-type",
              "code" : "asset-collection"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Library.subject[x]
          Definition

          A code or group definition that describes the intended subject of the contents of the library.

          ShortType of individual the library content is focused on
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from SubjectType
          (extensible to http://hl7.org/fhir/ValueSet/subject-type)

          The possible types of subjects for a library (E.g. Patient, Practitioner, Organization, Location, etc.).

          TypeChoice of: CodeableConcept, Reference(Group)
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Meaning if MissingPatient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Library.date
          Definition

          The date (and optionally time) when the library was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the library changes.

          ShortDate last changed
          Comments

          Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the library. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesRevision Date
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Library.publisher
          Definition

          The name of the organization or individual that published the library.

          ShortName of the publisher (organization or individual)
          Comments

          Usually an organization but may be an individual. The publisher (or steward) of the library is the organization or individual primarily responsible for the maintenance and upkeep of the library. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the library. This item SHOULD be populated unless the information is available from context.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Helps establish the "authority/credibility" of the library. May also allow for contact.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Library.contact
          Definition

          Contact details to assist a user in finding and communicating with the publisher.

          ShortContact details for the publisher
          Comments

          May be a web site, an email address, a telephone number, etc.

          Control0..*
          TypeContactDetail
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Library.description
          Definition

          A free text natural language description of the library from a consumer's perspective.

          ShortNatural language description of the library
          Comments

          This description can be used to capture details such as why the library was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the library as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the library is presumed to be the predominant language in the place the library was created).

          Control0..1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Library.useContext
          Definition

          The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate library instances.

          ShortThe context that the content is intended to support
          Comments

          When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

          Control0..*
          TypeUsageContext
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Assist in searching for appropriate content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Library.useContext. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ code
          • 56. Library.useContext:qualityProgram
            Slice NamequalityProgram
            Definition

            Supporting the definition of Quality Pograms.

            ShortThe context that the content is intended to support
            Comments

            When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

            Control0..1
            TypeUsageContext
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Assist in searching for appropriate content.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Library.useContext:qualityProgram.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            60. Library.useContext:qualityProgram.extension
            Definition

            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.

            ShortAdditional content defined by implementations
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Library.useContext.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 62. Library.useContext:qualityProgram.code
              Definition

              A code that identifies the type of context being specified by this usage context.

              ShortType of context being specified
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from UsageContextType
              (extensible to http://hl7.org/fhir/ValueSet/usage-context-type)

              A code that specifies a type of context being specified by a usage context.

              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Pattern Value{
                "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
                "code" : "program"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              64. Library.useContext:qualityProgram.value[x]
              Definition

              Support the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs.

              ShortValue that defines the context
              Control1..1
              BindingFor example codes, see Quality Programs Example
              (example to http://hl7.org/fhir/us/cqfmeasures/ValueSet/quality-programs-example)

              Supports the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs

              TypeCodeableConcept
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. Library.jurisdiction
              Definition

              A legal or geographic region in which the library is intended to be used.

              ShortIntended jurisdiction for library (if applicable)
              Comments

              It may be possible for the library to be used in jurisdictions other than those for which it was originally designed or intended.

              Control0..*
              BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
              (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

              Countries and regions within which this artifact is targeted for use.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Library.purpose
              Definition

              Explanation of why this library is needed and why it has been designed as it has.

              ShortWhy this library is defined
              Comments

              This element does not describe the usage of the library. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this library.

              Control0..1
              Typemarkdown
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Library.usage
              Definition

              A detailed description of how the library is used from a clinical perspective.

              ShortDescribes the clinical usage of the library
              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. Library.copyright
              Definition

              A copyright statement relating to the library and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the library.

              ShortUse and/or publishing restrictions
              Control0..1
              Typemarkdown
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Consumers must be able to determine any legal restrictions on the use of the library and/or its content.

              Alternate NamesLicense, Restrictions
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. Library.approvalDate
              Definition

              The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

              ShortWhen the library was approved by publisher
              Comments

              The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

              Control0..1
              Typedate
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Library.lastReviewDate
              Definition

              The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

              ShortWhen the library was last reviewed
              Comments

              If specified, this date follows the original approval date.

              Control0..1
              Typedate
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Library.effectivePeriod
              Definition

              The period during which the library content was or is planned to be in active use.

              ShortWhen the library is expected to be used
              Comments

              The effective period for a library determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the library are or are expected to be used instead.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Library.topic
              Definition

              Descriptive topics related to the content of the library. Topics provide a high-level categorization of the library that can be useful for filtering and searching.

              ShortE.g. Education, Treatment, Assessment, etc.
              Control0..*
              BindingFor example codes, see DefinitionTopic
              (example to http://hl7.org/fhir/ValueSet/definition-topic)

              High-level categorization of the definition, used for searching, sorting, and filtering.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Repositories must be able to determine how to categorize the library so that it can be found by topical searches.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. Library.author
              Definition

              An individiual or organization primarily involved in the creation and maintenance of the content.

              ShortWho authored the content
              Control0..*
              TypeContactDetail
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. Library.editor
              Definition

              An individual or organization primarily responsible for internal coherence of the content.

              ShortWho edited the content
              Control0..*
              TypeContactDetail
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Library.reviewer
              Definition

              An individual or organization primarily responsible for review of some aspect of the content.

              ShortWho reviewed the content
              Control0..*
              TypeContactDetail
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. Library.endorser
              Definition

              An individual or organization responsible for officially endorsing the content for use in some setting.

              ShortWho endorsed the content
              Control0..*
              TypeContactDetail
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. Library.relatedArtifact
              Definition

              Related artifacts such as additional documentation, justification, or bibliographic references.

              ShortAdditional documentation, citations, etc.
              Comments

              Each related artifact is either an attachment, or a reference to another resource, but not both.

              Control0..*
              TypeRelatedArtifact
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Library.relatedArtifact. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ type
              • 92. Library.relatedArtifact:component
                Slice Namecomponent
                Definition

                A canonical resource (such as a Library, CodeSystem, or ValueSet) that is part of the manifest.

                ShortWhat components are in the manifest
                Comments

                This is the full list of component artifacts. Each component may be either a specific artifact (such as a Library, ValueSet, or Measure), or it may itself be an artifact manifest (i.e. a Library conforming to this profile) to allow manifest information (dependency version binding) to be specified per artifact, rather than requiring it all to be specified at the root level of the manifest).

                Control0..*
                TypeRelatedArtifact
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                Manifests must be able to unambiguously specify the set of components that make up the artifact collection. The version of each component SHALL be included in the canonical reference to the component.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                mnf-1: Component reference must be either a resourceReference (referencing a canonical promotion) or a canonical (referencing a canonical resource), but not both (resource.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-RelatedArtifact.resourceReference').exists())
                94. Library.relatedArtifact:component.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                96. Library.relatedArtifact:component.extension
                Definition

                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.

                ShortAdditional content defined by implementations
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Library.relatedArtifact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 98. Library.relatedArtifact:component.extension:isOwned
                  Slice NameisOwned
                  Definition

                  To provide an indication of whether or not a referenced artifact is owned in context of the referencing artifact and therefore if it's lifecycle is managed in that context.

                  ShortWhether or not the referenced artifact is owned by the referencing artifact.
                  Control0..1
                  TypeExtension(Artifact Is Owned) (Extension Type: boolean)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  100. Library.relatedArtifact:component.extension:resourceReference
                  Slice NameresourceReference
                  Definition

                  A reference to a canonical promotion of a FHIR resource (i.e. a non-canonical resource that has been promoted to a canonical resource so it can be used in definitional contexts).

                  ShortA reference to the component artifact (for canonical promotions)
                  Control0..1
                  This element is affected by the following invariants: mnf-1
                  TypeExtension(Extension Definition for RelatedArtifact.resourceReference for Version 5.0) (Extension Type: Reference(Resource))
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  102. Library.relatedArtifact:component.type
                  Definition

                  The type of relationship to the related artifact.

                  Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
                  Control1..1
                  BindingThe codes SHALL be taken from RelatedArtifactType
                  (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

                  The type of relationship to the related artifact.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Fixed Valuecomposed-of
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. Library.relatedArtifact:component.label
                  Definition

                  A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                  ShortShort label
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. Library.relatedArtifact:component.display
                  Definition

                  A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                  ShortBrief description of the related artifact
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. Library.relatedArtifact:component.citation
                  Definition

                  A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                  ShortBibliographic citation for the artifact
                  Comments

                  Additional structured information about citations should be captured as extensions.

                  Control0..1
                  Typemarkdown
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. Library.relatedArtifact:component.url
                  Definition

                  A url for the artifact that can be followed to access the actual content.

                  ShortWhere the artifact can be accessed
                  Comments

                  If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

                  Control0..1
                  Typeurl
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. Library.relatedArtifact:component.document
                  Definition

                  The document being referenced, represented as an attachment. This is exclusive with the resource element.

                  ShortWhat document is being referenced
                  Control0..1
                  TypeAttachment
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. Library.relatedArtifact:component.resource
                  Definition

                  The related resource, such as a library, value set, profile, or other knowledge resource.

                  ShortA reference to the component artifact (for canonical resources)
                  Comments

                  If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                  Control0..1
                  This element is affected by the following invariants: mnf-1
                  Typecanonical(Resource)
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  116. Library.relatedArtifact:dependency
                  Slice Namedependency
                  Definition

                  A canonical resource (such as a Library, CodeSystem, or ValueSet) referenced by any artifact in the release, or any dependency of any artifact in the release, recursively.

                  ShortWhat dependencies are referenced
                  Comments

                  This is the full list of dependencies of all artifacts used in the specification.

                  Control0..*
                  TypeRelatedArtifact
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Artifacts must be able to unambiguously specify the versions of all dependencies used by artifacts in a specification. The version of each dependency SHALL be included in the canonical reference to the dependency.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  mnf-2: Dependency reference must be either a resourceReference (referencing a canonical promotion) or a canonical (referencing a canonical resource), but not both (resource.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-RelatedArtifact.resourceReference').exists())
                  118. Library.relatedArtifact:dependency.id
                  Definition

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  120. Library.relatedArtifact:dependency.extension
                  Definition

                  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.

                  ShortAdditional content defined by implementations
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Library.relatedArtifact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 122. Library.relatedArtifact:dependency.extension:resourceReference
                    Slice NameresourceReference
                    Definition

                    A reference to a canonical promotion of a FHIR resource (i.e. a non-canonical resource that has been promoted to a canonical resource so it can be used in definitional contexts).

                    ShortA reference to the dependency artifact (for canonical promotions)
                    Control0..1
                    This element is affected by the following invariants: mnf-2
                    TypeExtension(Extension Definition for RelatedArtifact.resourceReference for Version 5.0) (Extension Type: Reference(Resource))
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    124. Library.relatedArtifact:dependency.type
                    Definition

                    The type of relationship to the related artifact.

                    Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
                    Control1..1
                    BindingThe codes SHALL be taken from RelatedArtifactType
                    (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

                    The type of relationship to the related artifact.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Fixed Valuedepends-on
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    126. Library.relatedArtifact:dependency.label
                    Definition

                    A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                    ShortShort label
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    128. Library.relatedArtifact:dependency.display
                    Definition

                    A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                    ShortBrief description of the related artifact
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    130. Library.relatedArtifact:dependency.citation
                    Definition

                    A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                    ShortBibliographic citation for the artifact
                    Comments

                    Additional structured information about citations should be captured as extensions.

                    Control0..1
                    Typemarkdown
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    132. Library.relatedArtifact:dependency.url
                    Definition

                    A url for the artifact that can be followed to access the actual content.

                    ShortWhere the artifact can be accessed
                    Comments

                    If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

                    Control0..1
                    Typeurl
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    134. Library.relatedArtifact:dependency.document
                    Definition

                    The document being referenced, represented as an attachment. This is exclusive with the resource element.

                    ShortWhat document is being referenced
                    Control0..1
                    TypeAttachment
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    136. Library.relatedArtifact:dependency.resource
                    Definition

                    The related resource, such as a library, value set, profile, or other knowledge resource.

                    ShortA reference to the dependency artifact (for canonical resources)
                    Comments

                    If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                    Control0..1
                    This element is affected by the following invariants: mnf-2
                    Typecanonical(Resource)
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    138. Library.parameter
                    Definition

                    The parameter element defines parameters used by the library.

                    ShortParameters defined by the library
                    Control0..*
                    TypeParameterDefinition
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    140. Library.dataRequirement
                    Definition

                    Describes a set of data that must be provided in order to be able to successfully perform the computations defined by the library.

                    ShortWhat data is referenced by this library
                    Control0..*
                    TypeDataRequirement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    142. Library.content
                    Definition

                    The content of the library as an Attachment. The content may be a reference to a url, or may be directly embedded as a base-64 string. Either way, the contentType of the attachment determines how to interpret the content.

                    ShortContents of the library, either embedded or referenced
                    Control0..0
                    TypeAttachment
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))