PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2 United States of America flag

PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

Resource Profile: ADI Composition Header ( Abstract )

Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Composition-Header Version: 2.1.0
Active as of 2024-10-07 Computable Name: ADICompositionHeader

This abstract profile defines constraints that represent common administrative and demographic concepts for advance directives information used in US Realm clinical documents.

This profile, largely based on the CCDA on FHIR US Realm Header profile, defines requirements that address specific exchange requirements for a composition containing a person's advance care plan information.

Conformance:

In the cases where the patient is not able to "write" the PACP contents due to literacy constraints or physical disability, e.g. hemiplegia, the patient/subject is still considered author of the content, and a data enterer will fill the role of physically creating the document by entering the author’s requested information into the system used to create the document.

Advance Directive Information versionNumber represents a numeric value used to version successive replacement documents. Best practice for systems that support distributed document creation and updating is to populate the versionNumber with the timestamp created from the date/time when the version of the document is created in the system. Note: this may or may not be equivalent to the timestamp integer for Composition.date. the versionNumber timestamp always will be equivalent to the Bundle.timestamp for the document.

To better align with CDA, versionNumber should be a string label generated by converting the ClinicalDocument.effectiveTime (or Composition.date) to UTC time (-0000) and then using the YYYYMMDDhhmmss as the version.

For documents created within a system will follow the pattern that the timestamp-label versionNumber will be equivalent to the timestamp of the Composition.date and the Bundle.timestamp. However, for unstructured historical documents uploaded into a system, the timestamp-label versionNumber will be equivalent to the timestamp of the the Bundle.timestamp, but the Composition.date will reflect the creation date of the original document.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Clinical Document

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Clinical Document This is an abstractprofile. Childprofiles: ADIPACPComposition, ADIPMOComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
... language S 1..1 code Language of the resource content
... extension 1..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:versionNumber S 1..1 CDVersionNumber(5.2.0-ballot) Version-specific identifier for composition
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 0..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Data Enterer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
.... InformantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Informant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatus S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)
... status 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type S 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category S 0..1 CodeableConcept Categorization of Composition
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
... subject S 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date S 1..1 dateTime Composition editing time
... author S 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... title S 1..1 string Human Readable name/title
... confidentiality 0..0
... custodian S 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... section
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Clinical Document This is an abstractprofile. Childprofiles: ADIPACPComposition, ADIPMOComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language S 1..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... versionNumber S 1..1 string Version-specific identifier for composition
URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 0..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Data Enterer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
.... InformantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Informant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatus S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
... status ?!Σ 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category SΣ 0..1 CodeableConcept Categorization of Composition
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter Σ 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date SΣ 1..1 dateTime Composition editing time
... author SΣ 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... title SΣ 1..1 string Human Readable name/title
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
Composition.categoryexamplePattern: LOINC Code 42348-3("Advance directives")
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Clinical Document This is an abstractprofile. Childprofiles: ADIPACPComposition, ADIPMOComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... versionNumber S 1..1 string Version-specific identifier for composition
URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 0..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Data Enterer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
.... InformantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Informant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatus S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
... status ?!Σ 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category SΣ 0..1 CodeableConcept Categorization of Composition
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter Σ 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date SΣ 1..1 dateTime Composition editing time
... author SΣ 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... title SΣ 1..1 string Human Readable name/title
... attester 0..* BackboneElement Attests to accuracy of composition
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... mode 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.

.... time 0..1 dateTime When the composition was attested
.... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... relatesTo 0..* BackboneElement Relationships to other compositions/documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target[x] 1..1 Target of the relationship
..... targetIdentifier Identifier
..... targetReference Reference(Composition)
... event Σ 0..* BackboneElement The clinical service(s) being documented
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 0..* CodeableConcept Code(s) that apply to the event being documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period Σ 0..1 Period The period covered by the documentation
.... detail Σ 0..* Reference(Resource) The event(s) being documented
... section C 0..* BackboneElement Composition is broken into sections
cmp-1: A section must contain at least one of text, entries, or sub-sections
cmp-2: A section can only have an emptyReason if it is empty
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... title 0..1 string Label for section (e.g. for ToC)
.... code 0..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.

.... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
.... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
.... text C 0..1 Narrative Text summary of the section, for human interpretation
.... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

.... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

.... entry C 0..* Reference(Resource) A reference to data that supports this section
.... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

.... section C 0..* See section (Composition) Nested Section

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
Composition.categoryexamplePattern: LOINC Code 42348-3("Advance directives")
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
Composition.attester.moderequiredCompositionAttestationMode
http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
from the FHIR Standard
Composition.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
Composition.event.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.codeexampleDocumentSectionCodes
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard

Differential View

This structure is derived from Clinical Document

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Clinical Document This is an abstractprofile. Childprofiles: ADIPACPComposition, ADIPMOComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
... language S 1..1 code Language of the resource content
... extension 1..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:versionNumber S 1..1 CDVersionNumber(5.2.0-ballot) Version-specific identifier for composition
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 0..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Data Enterer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
.... InformantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Informant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatus S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)
... status 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type S 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category S 0..1 CodeableConcept Categorization of Composition
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
... subject S 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date S 1..1 dateTime Composition editing time
... author S 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... title S 1..1 string Human Readable name/title
... confidentiality 0..0
... custodian S 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... section
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Clinical Document This is an abstractprofile. Childprofiles: ADIPACPComposition, ADIPMOComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language S 1..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... versionNumber S 1..1 string Version-specific identifier for composition
URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 0..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Data Enterer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
.... InformantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Informant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatus S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
... status ?!Σ 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category SΣ 0..1 CodeableConcept Categorization of Composition
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter Σ 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date SΣ 1..1 dateTime Composition editing time
... author SΣ 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... title SΣ 1..1 string Human Readable name/title
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
Composition.categoryexamplePattern: LOINC Code 42348-3("Advance directives")
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Clinical Document This is an abstractprofile. Childprofiles: ADIPACPComposition, ADIPMOComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... versionNumber S 1..1 string Version-specific identifier for composition
URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 0..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Data Enterer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
.... InformantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) Informant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatus S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
... status ?!Σ 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category SΣ 0..1 CodeableConcept Categorization of Composition
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter Σ 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date SΣ 1..1 dateTime Composition editing time
... author SΣ 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... title SΣ 1..1 string Human Readable name/title
... attester 0..* BackboneElement Attests to accuracy of composition
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... mode 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.

.... time 0..1 dateTime When the composition was attested
.... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... relatesTo 0..* BackboneElement Relationships to other compositions/documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target[x] 1..1 Target of the relationship
..... targetIdentifier Identifier
..... targetReference Reference(Composition)
... event Σ 0..* BackboneElement The clinical service(s) being documented
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 0..* CodeableConcept Code(s) that apply to the event being documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period Σ 0..1 Period The period covered by the documentation
.... detail Σ 0..* Reference(Resource) The event(s) being documented
... section C 0..* BackboneElement Composition is broken into sections
cmp-1: A section must contain at least one of text, entries, or sub-sections
cmp-2: A section can only have an emptyReason if it is empty
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... title 0..1 string Label for section (e.g. for ToC)
.... code 0..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.

.... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
.... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
.... text C 0..1 Narrative Text summary of the section, for human interpretation
.... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

.... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

.... entry C 0..* Reference(Resource) A reference to data that supports this section
.... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

.... section C 0..* See section (Composition) Nested Section

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
Composition.categoryexamplePattern: LOINC Code 42348-3("Advance directives")
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
Composition.attester.moderequiredCompositionAttestationMode
http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
from the FHIR Standard
Composition.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
Composition.event.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.codeexampleDocumentSectionCodes
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard

 

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