PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot US

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot 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: 2.0.0-ballot
Standards status: Trial-use Maturity Level: 2 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 Personal ACP 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.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Composition C 0..* ClinicalDocumentComposition This is an abstract profile. Child profiles: ADIPMOComposition, ADIPACPComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
Constraints: clindoc-limit-participantType
... 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
... text S 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... extension:R5-Composition-version S 0..1 string Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version
.... extension:data-enterer S 0..1 (Complex) A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension
.... extension:informant S 0..* (Complex) An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension
.... extension:information-recipient S 0..* (Complex) An Information Recipient is the intended recipient of the information at the time the document was created.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension
.... extension:participant S 0..* (Complex) A Participant that is not a data-enter, information-recipient nor an informant
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension
.... extension:consent S 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension
.... extension:basedOn S 0..* Reference(Resource) The clinical action, such as a plan, proposal or order that is fulfilled by or precipitated this FHIR Clinical Document, such as a radiologists report of an x-ray.
URL: http://hl7.org/fhir/StructureDefinition/event-basedOn
.... extension:change-made S 0..1 (Complex) Note of changes made, calculating changes maybe required for safety as this extension may not contain all changes. Experimental, may overlap with other elements such as FHIR R6 note.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
.... extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
.... extension:Jurisdiction 0..* CodeableConcept US State or local jurisdiction
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
.... extension: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
.... 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
.... extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
.... 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
.... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... 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)
... Slices for modifierExtension ?! 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modifierExtension:R5-Composition-status ?!S 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status
... 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 Healthcare Directive Document Types Grouper . (extensible)
... Slices for category SΣ 2..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by value:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
.... category:clinicalnotecategory SΣ 1..1 CodeableConcept Category for Clinical Note
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: 107903-7
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical note
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... category:advanceDirectiveCategory SΣ 1..1 CodeableConcept Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC . (extensible)

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 healthcare 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
... Slices for attester S 0..* BackboneElement Attests to accuracy of composition
Slice: Unordered, Open by value:mode
.... attester:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... mode S 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
..... time S 0..1 dateTime When the composition was attested
..... party S 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
.... attester:legal_attester S 0..1 BackboneElement aka legal authenticator
..... 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.
Required Pattern: legal
.... attester:professional_attester S 0..* BackboneElement aka authenticator
..... 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.
Required Pattern: professional
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... Slices for relatesTo S 0..* BackboneElement Relationships to other compositions/documents
Slice: Unordered, Open by value:code, type:target
.... relatesTo:All Slices Content/Rules for all slices
..... 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.
..... Slices for target[x] 1..1 Target of the relationship
Slice: Unordered, Open by type:$this
...... targetIdentifier Identifier
...... targetReference Reference(Composition)
...... target[x]:targetIdentifier 0..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document
.... relatesTo:replaced_document S 0..* BackboneElement The document(s) being superceded
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
Required Pattern: replaces
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being replaced, or to some other identifier of a non FHIR document
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
.... relatesTo:appended_document S 0..* BackboneElement The document(s) being appended too
..... 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.
Required Pattern: appends
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Target of the relationship
....... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
... Slices for section SC 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
Constraints: cmp-1, cmp-2
.... section:All Slices Content/Rules for all slices
..... Slices for extension Content/Rules for all slices
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 0..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
..... text SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... section:advance_directive_source_form SC 1..1 BackboneElement Advance directive source form
Constraints: cmp-1, cmp-2
..... Slices for extension Content/Rules for all slices
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: advance_directive_source_form
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... text SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
..... entry C 0..* Reference(ADI Source Form) A reference to data that supports this section

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Composition.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Composition.status Base required ADI Composition Status 📦2.0.0-ballot This IG
Composition.type Base extensible Advance Healthcare Directive Document Types Grouper . 📦20250407 VSAC v0.24
Composition.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:clinicalnotecategory Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:advanceDirectiveCategory Base extensible Advance Healthcare Directive Categories LOINC . 📦20250402 VSAC v0.24
Composition.attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:legal_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:professional_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.section.​code Base example Document Section Codes 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​code Base example Document Section Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
clindoc-limit-participantType error Composition The R4 FHIR Clinical Document Composition Profile contains specific extensions for data entry person, informant, information recipient, primary information recipient and tracker. So, they are not allowed in the participant extension in the R4 profile. In R6, the intention is to have dedicated-named slices of a backbone element. extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='ENT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='INF').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='IRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='PRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='TRC').not()
cmp-1 error Composition.section, Composition.section:advance_directive_source_form A section must contain at least one of text, entries, or sub-sections text.exists() or entry.exists() or section.exists()
cmp-2 error Composition.section, Composition.section:advance_directive_source_form A section can only have an emptyReason if it is empty emptyReason.empty() or entry.empty()
dom-2 error Composition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Composition 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 error Composition 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 error Composition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Composition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from ClinicalDocumentComposition

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Composition ClinicalDocumentComposition This is an abstract profile. Child profiles: ADIPMOComposition, ADIPACPComposition
... language 1..1 code Language of the resource content
... Slices for extension Content/Rules for all slices
.... extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
.... extension:Jurisdiction 0..* CodeableConcept US State or local jurisdiction
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
.... extension: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
.... 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
.... extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
.... 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
.... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... 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 1..1 Identifier Version-independent identifier for the Composition
... type 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Healthcare Directive Document Types Grouper . (extensible)
... category 2..* CodeableConcept Categorization of Composition
... Slices for category Content/Rules for all slices
.... category:advanceDirectiveCategory S 1..1 CodeableConcept Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC . (extensible)
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 healthcare directives
... subject 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
... author 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... confidentiality 0..0 As defined by affinity domain
... custodian 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... event
.... code 0..* CodeableConcept Code(s) that apply to the event being documented
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: acp-services
...... display 1..1 string Representation defined by the system
Fixed Value: Advance care planning services
.... Slices for detail 0..* Reference(Resource) The event(s) being documented
Slice: Unordered, Open by profile:resolve()
..... detail:adiFacilitator 0..1 Reference(ADI Facilitator) ADI Facilitator
... Slices for section 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
.... section:All Slices Content/Rules for all slices
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... text 1..1 Narrative Text summary of the section, for human interpretation
.... section:advance_directive_source_form S 1..1 BackboneElement Advance directive source form
..... code 1..1 CodeableConcept Classification of section (recommended)
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: advance_directive_source_form
..... entry 0..* Reference(ADI Source Form) A reference to data that supports this section

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Composition.status Base required ADI Composition Status 📦2.0.0-ballot This IG
Composition.type Base extensible Advance Healthcare Directive Document Types Grouper . 📦20250407 VSAC v0.24
Composition.category:advanceDirectiveCategory Base extensible Advance Healthcare Directive Categories LOINC . 📦20250402 VSAC v0.24
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Composition C 0..* ClinicalDocumentComposition This is an abstract profile. Child profiles: ADIPMOComposition, ADIPACPComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
Constraints: clindoc-limit-participantType
... 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 S 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:R5-Composition-version S 0..1 string Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version
.... extension:data-enterer S 0..1 (Complex) A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension
.... extension:informant S 0..* (Complex) An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension
.... extension:information-recipient S 0..* (Complex) An Information Recipient is the intended recipient of the information at the time the document was created.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension
.... extension:participant S 0..* (Complex) A Participant that is not a data-enter, information-recipient nor an informant
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension
.... extension:consent S 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension
.... extension:basedOn S 0..* Reference(Resource) The clinical action, such as a plan, proposal or order that is fulfilled by or precipitated this FHIR Clinical Document, such as a radiologists report of an x-ray.
URL: http://hl7.org/fhir/StructureDefinition/event-basedOn
.... extension:change-made S 0..1 (Complex) Note of changes made, calculating changes maybe required for safety as this extension may not contain all changes. Experimental, may overlap with other elements such as FHIR R6 note.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
.... extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
.... extension:Jurisdiction 0..* CodeableConcept US State or local jurisdiction
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
.... extension: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
.... 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
.... extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
.... 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
.... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... 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)
... Slices for modifierExtension ?! 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modifierExtension:R5-Composition-status ?!S 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status
... 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 Healthcare Directive Document Types Grouper . (extensible)
... Slices for category SΣ 2..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by value:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
.... category:clinicalnotecategory SΣ 1..1 CodeableConcept Category for Clinical Note
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: 107903-7
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical note
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... category:advanceDirectiveCategory SΣ 1..1 CodeableConcept Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC . (extensible)

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 healthcare 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
... Slices for attester S 0..* BackboneElement Attests to accuracy of composition
Slice: Unordered, Open by value:mode
.... attester:All Slices Content/Rules for all slices
..... 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 S 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
..... time S 0..1 dateTime When the composition was attested
..... party S 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
.... attester:legal_attester S 0..1 BackboneElement aka legal authenticator
..... 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.
Required Pattern: legal
..... time 0..1 dateTime When the composition was attested
..... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
.... attester:professional_attester S 0..* BackboneElement aka authenticator
..... 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.
Required Pattern: professional
..... 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
... Slices for relatesTo S 0..* BackboneElement Relationships to other compositions/documents
Slice: Unordered, Open by value:code, type:target
.... relatesTo:All Slices Content/Rules for all slices
..... 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.
..... Slices for target[x] 1..1 Target of the relationship
Slice: Unordered, Open by type:$this
...... targetIdentifier Identifier
...... targetReference Reference(Composition)
...... target[x]:targetIdentifier 0..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document
.... relatesTo:replaced_document S 0..* BackboneElement The document(s) being superceded
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
Required Pattern: replaces
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being replaced, or to some other identifier of a non FHIR document
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
....... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
....... period Σ 0..1 Period Time period when id is/was valid for use
....... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... relatesTo:appended_document S 0..* BackboneElement The document(s) being appended too
..... 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.
Required Pattern: appends
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Target of the relationship
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
....... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
....... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 0..1 string The value that is unique
Example General: 123456
....... period Σ 0..1 Period Time period when id is/was valid for use
....... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... 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.

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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: acp-services
...... display 1..1 string Representation defined by the system
Fixed Value: Advance care planning services
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... period Σ 0..1 Period The period covered by the documentation
.... Slices for detail Σ 0..* Reference(Resource) The event(s) being documented
Slice: Unordered, Open by profile:resolve()
..... detail:adiFacilitator Σ 0..1 Reference(ADI Facilitator) ADI Facilitator
... Slices for section SC 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
Constraints: cmp-1, cmp-2
.... section:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 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 SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
..... 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
.... section:advance_directive_source_form SC 1..1 BackboneElement Advance directive source form
Constraints: cmp-1, cmp-2
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: advance_directive_source_form
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... 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 SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
..... 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(ADI Source Form) 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

Path Status Usage ValueSet Version Source
Composition.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Composition.status Base required ADI Composition Status 📦2.0.0-ballot This IG
Composition.type Base extensible Advance Healthcare Directive Document Types Grouper . 📦20250407 VSAC v0.24
Composition.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:clinicalnotecategory Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:advanceDirectiveCategory Base extensible Advance Healthcare Directive Categories LOINC . 📦20250402 VSAC v0.24
Composition.attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:legal_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:professional_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​target[x]:targetIdentifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​target[x]:targetIdentifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Composition.event.code Base example v3 Code System ActCode 📦3.0.0 THO v7.1
Composition.section.​code Base example Document Section Codes 📍4.0.1 FHIR Std.
Composition.section.​mode Base required ListMode 📍4.0.1 FHIR Std.
Composition.section.​orderedBy Base preferred List Order Codes 📍4.0.1 FHIR Std.
Composition.section.​emptyReason Base preferred List Empty Reasons 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​code Base example Document Section Codes 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​mode Base required ListMode 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​orderedBy Base preferred List Order Codes 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​emptyReason Base preferred List Empty Reasons 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
clindoc-limit-participantType error Composition The R4 FHIR Clinical Document Composition Profile contains specific extensions for data entry person, informant, information recipient, primary information recipient and tracker. So, they are not allowed in the participant extension in the R4 profile. In R6, the intention is to have dedicated-named slices of a backbone element. extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='ENT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='INF').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='IRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='PRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='TRC').not()
cmp-1 error Composition.section, Composition.section:advance_directive_source_form A section must contain at least one of text, entries, or sub-sections text.exists() or entry.exists() or section.exists()
cmp-2 error Composition.section, Composition.section:advance_directive_source_form A section can only have an emptyReason if it is empty emptyReason.empty() or entry.empty()
dom-2 error Composition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Composition 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 error Composition 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 error Composition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Composition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from ClinicalDocumentComposition

Summary

Mandatory: 7 elements
Must-Support: 3 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Composition.event.detail
  • The element 1 is sliced based on the value of Composition.section

Maturity: 2

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Composition C 0..* ClinicalDocumentComposition This is an abstract profile. Child profiles: ADIPMOComposition, ADIPACPComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
Constraints: clindoc-limit-participantType
... 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
... text S 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... extension:R5-Composition-version S 0..1 string Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version
.... extension:data-enterer S 0..1 (Complex) A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension
.... extension:informant S 0..* (Complex) An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension
.... extension:information-recipient S 0..* (Complex) An Information Recipient is the intended recipient of the information at the time the document was created.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension
.... extension:participant S 0..* (Complex) A Participant that is not a data-enter, information-recipient nor an informant
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension
.... extension:consent S 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension
.... extension:basedOn S 0..* Reference(Resource) The clinical action, such as a plan, proposal or order that is fulfilled by or precipitated this FHIR Clinical Document, such as a radiologists report of an x-ray.
URL: http://hl7.org/fhir/StructureDefinition/event-basedOn
.... extension:change-made S 0..1 (Complex) Note of changes made, calculating changes maybe required for safety as this extension may not contain all changes. Experimental, may overlap with other elements such as FHIR R6 note.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
.... extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
.... extension:Jurisdiction 0..* CodeableConcept US State or local jurisdiction
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
.... extension: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
.... 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
.... extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
.... 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
.... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... 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)
... Slices for modifierExtension ?! 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modifierExtension:R5-Composition-status ?!S 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status
... 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 Healthcare Directive Document Types Grouper . (extensible)
... Slices for category SΣ 2..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by value:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
.... category:clinicalnotecategory SΣ 1..1 CodeableConcept Category for Clinical Note
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: 107903-7
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical note
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... category:advanceDirectiveCategory SΣ 1..1 CodeableConcept Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC . (extensible)

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 healthcare 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
... Slices for attester S 0..* BackboneElement Attests to accuracy of composition
Slice: Unordered, Open by value:mode
.... attester:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... mode S 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
..... time S 0..1 dateTime When the composition was attested
..... party S 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
.... attester:legal_attester S 0..1 BackboneElement aka legal authenticator
..... 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.
Required Pattern: legal
.... attester:professional_attester S 0..* BackboneElement aka authenticator
..... 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.
Required Pattern: professional
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... Slices for relatesTo S 0..* BackboneElement Relationships to other compositions/documents
Slice: Unordered, Open by value:code, type:target
.... relatesTo:All Slices Content/Rules for all slices
..... 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.
..... Slices for target[x] 1..1 Target of the relationship
Slice: Unordered, Open by type:$this
...... targetIdentifier Identifier
...... targetReference Reference(Composition)
...... target[x]:targetIdentifier 0..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document
.... relatesTo:replaced_document S 0..* BackboneElement The document(s) being superceded
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
Required Pattern: replaces
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being replaced, or to some other identifier of a non FHIR document
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
.... relatesTo:appended_document S 0..* BackboneElement The document(s) being appended too
..... 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.
Required Pattern: appends
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Target of the relationship
....... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
... Slices for section SC 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
Constraints: cmp-1, cmp-2
.... section:All Slices Content/Rules for all slices
..... Slices for extension Content/Rules for all slices
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 0..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
..... text SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... section:advance_directive_source_form SC 1..1 BackboneElement Advance directive source form
Constraints: cmp-1, cmp-2
..... Slices for extension Content/Rules for all slices
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: advance_directive_source_form
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... text SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
..... entry C 0..* Reference(ADI Source Form) A reference to data that supports this section

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Composition.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Composition.status Base required ADI Composition Status 📦2.0.0-ballot This IG
Composition.type Base extensible Advance Healthcare Directive Document Types Grouper . 📦20250407 VSAC v0.24
Composition.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:clinicalnotecategory Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:advanceDirectiveCategory Base extensible Advance Healthcare Directive Categories LOINC . 📦20250402 VSAC v0.24
Composition.attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:legal_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:professional_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.section.​code Base example Document Section Codes 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​code Base example Document Section Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
clindoc-limit-participantType error Composition The R4 FHIR Clinical Document Composition Profile contains specific extensions for data entry person, informant, information recipient, primary information recipient and tracker. So, they are not allowed in the participant extension in the R4 profile. In R6, the intention is to have dedicated-named slices of a backbone element. extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='ENT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='INF').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='IRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='PRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='TRC').not()
cmp-1 error Composition.section, Composition.section:advance_directive_source_form A section must contain at least one of text, entries, or sub-sections text.exists() or entry.exists() or section.exists()
cmp-2 error Composition.section, Composition.section:advance_directive_source_form A section can only have an emptyReason if it is empty emptyReason.empty() or entry.empty()
dom-2 error Composition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Composition 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 error Composition 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 error Composition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Composition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from ClinicalDocumentComposition

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Composition ClinicalDocumentComposition This is an abstract profile. Child profiles: ADIPMOComposition, ADIPACPComposition
... language 1..1 code Language of the resource content
... Slices for extension Content/Rules for all slices
.... extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
.... extension:Jurisdiction 0..* CodeableConcept US State or local jurisdiction
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
.... extension: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
.... 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
.... extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
.... 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
.... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... 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 1..1 Identifier Version-independent identifier for the Composition
... type 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Healthcare Directive Document Types Grouper . (extensible)
... category 2..* CodeableConcept Categorization of Composition
... Slices for category Content/Rules for all slices
.... category:advanceDirectiveCategory S 1..1 CodeableConcept Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC . (extensible)
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 healthcare directives
... subject 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
... author 1..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) Who and/or what authored the composition
... confidentiality 0..0 As defined by affinity domain
... custodian 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... event
.... code 0..* CodeableConcept Code(s) that apply to the event being documented
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: acp-services
...... display 1..1 string Representation defined by the system
Fixed Value: Advance care planning services
.... Slices for detail 0..* Reference(Resource) The event(s) being documented
Slice: Unordered, Open by profile:resolve()
..... detail:adiFacilitator 0..1 Reference(ADI Facilitator) ADI Facilitator
... Slices for section 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
.... section:All Slices Content/Rules for all slices
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... text 1..1 Narrative Text summary of the section, for human interpretation
.... section:advance_directive_source_form S 1..1 BackboneElement Advance directive source form
..... code 1..1 CodeableConcept Classification of section (recommended)
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: advance_directive_source_form
..... entry 0..* Reference(ADI Source Form) A reference to data that supports this section

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Composition.status Base required ADI Composition Status 📦2.0.0-ballot This IG
Composition.type Base extensible Advance Healthcare Directive Document Types Grouper . 📦20250407 VSAC v0.24
Composition.category:advanceDirectiveCategory Base extensible Advance Healthcare Directive Categories LOINC . 📦20250402 VSAC v0.24

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Composition C 0..* ClinicalDocumentComposition This is an abstract profile. Child profiles: ADIPMOComposition, ADIPACPComposition
A set of resources composed into a single coherent clinical statement with clinical attestation
Constraints: clindoc-limit-participantType
... 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 S 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:R5-Composition-version S 0..1 string Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version
.... extension:data-enterer S 0..1 (Complex) A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension
.... extension:informant S 0..* (Complex) An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension
.... extension:information-recipient S 0..* (Complex) An Information Recipient is the intended recipient of the information at the time the document was created.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension
.... extension:participant S 0..* (Complex) A Participant that is not a data-enter, information-recipient nor an informant
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension
.... extension:consent S 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension
.... extension:basedOn S 0..* Reference(Resource) The clinical action, such as a plan, proposal or order that is fulfilled by or precipitated this FHIR Clinical Document, such as a radiologists report of an x-ray.
URL: http://hl7.org/fhir/StructureDefinition/event-basedOn
.... extension:change-made S 0..1 (Complex) Note of changes made, calculating changes maybe required for safety as this extension may not contain all changes. Experimental, may overlap with other elements such as FHIR R6 note.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
.... extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
.... extension:Jurisdiction 0..* CodeableConcept US State or local jurisdiction
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
.... extension: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
.... 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
.... extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
.... 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
.... extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... 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)
... Slices for modifierExtension ?! 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modifierExtension:R5-Composition-status ?!S 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status
... 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 Healthcare Directive Document Types Grouper . (extensible)
... Slices for category SΣ 2..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by value:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
.... category:clinicalnotecategory SΣ 1..1 CodeableConcept Category for Clinical Note
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: 107903-7
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical note
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... category:advanceDirectiveCategory SΣ 1..1 CodeableConcept Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC . (extensible)

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 healthcare 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
... Slices for attester S 0..* BackboneElement Attests to accuracy of composition
Slice: Unordered, Open by value:mode
.... attester:All Slices Content/Rules for all slices
..... 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 S 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
..... time S 0..1 dateTime When the composition was attested
..... party S 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
.... attester:legal_attester S 0..1 BackboneElement aka legal authenticator
..... 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.
Required Pattern: legal
..... time 0..1 dateTime When the composition was attested
..... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
.... attester:professional_attester S 0..* BackboneElement aka authenticator
..... 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.
Required Pattern: professional
..... 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
... Slices for relatesTo S 0..* BackboneElement Relationships to other compositions/documents
Slice: Unordered, Open by value:code, type:target
.... relatesTo:All Slices Content/Rules for all slices
..... 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.
..... Slices for target[x] 1..1 Target of the relationship
Slice: Unordered, Open by type:$this
...... targetIdentifier Identifier
...... targetReference Reference(Composition)
...... target[x]:targetIdentifier 0..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document
.... relatesTo:replaced_document S 0..* BackboneElement The document(s) being superceded
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
Required Pattern: replaces
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being replaced, or to some other identifier of a non FHIR document
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
....... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
....... period Σ 0..1 Period Time period when id is/was valid for use
....... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... relatesTo:appended_document S 0..* BackboneElement The document(s) being appended too
..... 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.
Required Pattern: appends
..... Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this
...... target[x]:targetIdentifier 1..1 Identifier Target of the relationship
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
....... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
....... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 0..1 string The value that is unique
Example General: 123456
....... period Σ 0..1 Period Time period when id is/was valid for use
....... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... 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.

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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: acp-services
...... display 1..1 string Representation defined by the system
Fixed Value: Advance care planning services
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... period Σ 0..1 Period The period covered by the documentation
.... Slices for detail Σ 0..* Reference(Resource) The event(s) being documented
Slice: Unordered, Open by profile:resolve()
..... detail:adiFacilitator Σ 0..1 Reference(ADI Facilitator) ADI Facilitator
... Slices for section SC 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
Constraints: cmp-1, cmp-2
.... section:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 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 SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
..... 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
.... section:advance_directive_source_form SC 1..1 BackboneElement Advance directive source form
Constraints: cmp-1, cmp-2
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:change-made S 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
...... extension: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 S 1..1 string Label for section (e.g. for ToC)
..... code S 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: advance_directive_source_form
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... 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 SC 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
..... 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(ADI Source Form) 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

Path Status Usage ValueSet Version Source
Composition.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Composition.status Base required ADI Composition Status 📦2.0.0-ballot This IG
Composition.type Base extensible Advance Healthcare Directive Document Types Grouper . 📦20250407 VSAC v0.24
Composition.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:clinicalnotecategory Base example Document Class Value Set 📍4.0.1 FHIR Std.
Composition.category:advanceDirectiveCategory Base extensible Advance Healthcare Directive Categories LOINC . 📦20250402 VSAC v0.24
Composition.attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:legal_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.attester:professional_attester.​mode Base required CompositionAttestationMode 📍4.0.1 FHIR Std.
Composition.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.relatesTo:replaced_document.​target[x]:targetIdentifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​target[x]:targetIdentifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Composition.relatesTo:appended_document.​target[x]:targetIdentifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Composition.event.code Base example v3 Code System ActCode 📦3.0.0 THO v7.1
Composition.section.​code Base example Document Section Codes 📍4.0.1 FHIR Std.
Composition.section.​mode Base required ListMode 📍4.0.1 FHIR Std.
Composition.section.​orderedBy Base preferred List Order Codes 📍4.0.1 FHIR Std.
Composition.section.​emptyReason Base preferred List Empty Reasons 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​code Base example Document Section Codes 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​mode Base required ListMode 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​orderedBy Base preferred List Order Codes 📍4.0.1 FHIR Std.
Composition.section:advance_directive_source_form.​emptyReason Base preferred List Empty Reasons 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
clindoc-limit-participantType error Composition The R4 FHIR Clinical Document Composition Profile contains specific extensions for data entry person, informant, information recipient, primary information recipient and tracker. So, they are not allowed in the participant extension in the R4 profile. In R6, the intention is to have dedicated-named slices of a backbone element. extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='ENT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='INF').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='IRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='PRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='TRC').not()
cmp-1 error Composition.section, Composition.section:advance_directive_source_form A section must contain at least one of text, entries, or sub-sections text.exists() or entry.exists() or section.exists()
cmp-2 error Composition.section, Composition.section:advance_directive_source_form A section can only have an emptyReason if it is empty emptyReason.empty() or entry.empty()
dom-2 error Composition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Composition 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 error Composition 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 error Composition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Composition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from ClinicalDocumentComposition

Summary

Mandatory: 7 elements
Must-Support: 3 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Composition.event.detail
  • The element 1 is sliced based on the value of Composition.section

Maturity: 2

 

Other representations of profile: CSV, Excel, Schematron