QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

## Resource Profile: QICoreCommunicationNotDone - JSON Profile

Page standards status: Trial-use | Maturity Level: 4

JSON representation of the qicore-communicationnotdone resource profile.

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    {
      "resourceType" : "StructureDefinition",
      "id" : "qicore-communicationnotdone",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition qicore-communicationnotdone</b></p><a name=\"qicore-communicationnotdone\"> </a><a name=\"hcqicore-communicationnotdone\"> </a><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-communicationnotdone-definitions.html#Communication\">Communication</a><a name=\"Communication\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"StructureDefinition-qicore-communication.html\">QICoreCommunication</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">A record of information transmitted from a sender to a receiver</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> Slices for extension<a name=\"Communication.extension\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck124.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-communicationnotdone-definitions.html#Communication.extension:event-recorded\" title=\"Extension URL = http://hl7.org/fhir/StructureDefinition/event-recorded\">extension:event-recorded</a><a name=\"Communication.extension.2\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">(QI) Captures the recorded date of the communication<br/><span style=\"font-weight:bold\">URL: </span><a href=\"http://hl7.org/fhir/extensions/5.2.0/StructureDefinition-event-recorded.html\">http://hl7.org/fhir/StructureDefinition/event-recorded</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-communicationnotdone-definitions.html#Communication.status\">status</a><a name=\"Communication.status\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">(QI) not-done<br/><span style=\"font-weight:bold\">Fixed Value: </span><span style=\"color: darkgreen\">not-done</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-communicationnotdone-definitions.html#Communication.statusReason\">statusReason</a><a name=\"Communication.statusReason\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5; opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">(QI) Reason for current status<br class=\"binding\"/><span style=\"font-weight:bold\" title=\"null\" class=\"binding\">Binding: </span><a href=\"ValueSet-qicore-negation-reason.html\" title=\"http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason\" class=\"binding\">QICore Negation Reason Codes</a><span title=\"null\" class=\"binding\"> (</span><a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\" class=\"binding\">extensible</a><span title=\"null\" class=\"binding\">)</span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-primaryCodePath",
          "valueString" : "topic"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-isIncluded",
          "valueBoolean" : true
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-isRetrievable",
          "valueBoolean" : true
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-label",
          "valueString" : "CommunicationNotDone"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
          "valueCode" : "cqi"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
          "valueInteger" : 4,
          "_valueInteger" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
                "valueCanonical" : "http://hl7.org/fhir/us/qicore/ImplementationGuide/us-qicore"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "trial-use",
          "_valueCode" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
                "valueCanonical" : "http://hl7.org/fhir/us/qicore/ImplementationGuide/us-qicore"
              }
            ]
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone",
      "version" : "7.0.2",
      "name" : "QICoreCommunicationNotDone",
      "title" : "QICore Communication Not Done",
      "status" : "active",
      "experimental" : false,
      "date" : "2023-08-01",
      "publisher" : "HL7 International / Clinical Quality Information",
      "contact" : [
        {
          "name" : "Clinical Quality Information WG",
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/cqi"
            }
          ]
        }
      ],
      "description" : "Negation profile of Communication for decision support/quality metrics. Indicates that the communication was not performed for a reason.",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "US"
            }
          ]
        }
      ],
      "fhirVersion" : "4.0.1",
      "mapping" : [
        {
          "identity" : "workflow",
          "uri" : "http://hl7.org/fhir/workflow",
          "name" : "Workflow Pattern"
        },
        {
          "identity" : "w5",
          "uri" : "http://hl7.org/fhir/fivews",
          "name" : "FiveWs Pattern Mapping"
        },
        {
          "identity" : "rim",
          "uri" : "http://hl7.org/v3",
          "name" : "RIM Mapping"
        }
      ],
      "kind" : "resource",
      "abstract" : false,
      "type" : "Communication",
      "baseDefinition" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication",
      "derivation" : "constraint",
      "snapshot" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
            "valueString" : "7.0.2"
          }
        ],
        "element" : [
          {
            "id" : "Communication",
            "path" : "Communication",
            "short" : "A record of information transmitted from a sender to a receiver",
            "definition" : "An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about a reportable condition.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication",
              "min" : 0,
              "max" : "*"
            },
            "constraint" : [
              {
                "key" : "dom-2",
                "severity" : "error",
                "human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                "expression" : "contained.contained.empty()",
                "xpath" : "not(parent::f:contained and f:contained)",
                "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
              },
              {
                "key" : "dom-3",
                "severity" : "error",
                "human" : "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
                "expression" : "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()",
                "xpath" : "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
                "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
              },
              {
                "key" : "dom-4",
                "severity" : "error",
                "human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                "expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                "xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
                "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
              },
              {
                "key" : "dom-5",
                "severity" : "error",
                "human" : "If a resource is contained in another resource, it SHALL NOT have a security label",
                "expression" : "contained.meta.security.empty()",
                "xpath" : "not(exists(f:contained/*/f:meta/f:security))",
                "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                    "valueBoolean" : true
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                    "valueMarkdown" : "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
                  }
                ],
                "key" : "dom-6",
                "severity" : "warning",
                "human" : "A resource should have narrative for robust management",
                "expression" : "text.`div`.exists()",
                "xpath" : "exists(f:text/h:div)",
                "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
              },
              {
                "key" : "com-1",
                "severity" : "error",
                "human" : "to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided",
                "expression" : "topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())",
                "source" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication"
              }
            ],
            "mustSupport" : false,
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "Entity. Role, or Act"
              },
              {
                "identity" : "workflow",
                "map" : "Event"
              }
            ]
          },
          {
            "id" : "Communication.id",
            "path" : "Communication.id",
            "short" : "Logical id of this artifact",
            "definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
            "comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Resource.id",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                    "valueUrl" : "id"
                  }
                ],
                "code" : "http://hl7.org/fhirpath/System.String"
              }
            ],
            "isModifier" : false,
            "isSummary" : true
          },
          {
            "id" : "Communication.meta",
            "path" : "Communication.meta",
            "short" : "Metadata about the resource",
            "definition" : "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Resource.meta",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "Meta"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true
          },
          {
            "id" : "Communication.implicitRules",
            "path" : "Communication.implicitRules",
            "short" : "A set of rules under which this content was created",
            "definition" : "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
            "comment" : "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Resource.implicitRules",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "uri"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : true,
            "isModifierReason" : "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
            "isSummary" : true
          },
          {
            "id" : "Communication.language",
            "path" : "Communication.language",
            "short" : "Language of the resource content",
            "definition" : "The base language in which the resource is written.",
            "comment" : "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Resource.language",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "code"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "binding" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                  "valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                  "valueString" : "Language"
                }
              ],
              "strength" : "preferred",
              "description" : "A human language.",
              "valueSet" : "http://hl7.org/fhir/ValueSet/languages|4.0.1"
            }
          },
          {
            "id" : "Communication.text",
            "path" : "Communication.text",
            "short" : "Text summary of the resource, for human interpretation",
            "definition" : "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
            "comment" : "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
            "alias" : [
              "narrative",
              "html",
              "xhtml",
              "display"
            ],
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "DomainResource.text",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "Narrative"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "Act.text?"
              }
            ]
          },
          {
            "id" : "Communication.contained",
            "path" : "Communication.contained",
            "short" : "Contained, inline Resources",
            "definition" : "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
            "comment" : "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
            "alias" : [
              "inline resources",
              "anonymous resources",
              "contained resources"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "DomainResource.contained",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Resource"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "N/A"
              }
            ]
          },
          {
            "id" : "Communication.extension",
            "path" : "Communication.extension",
            "slicing" : {
              "discriminator" : [
                {
                  "type" : "value",
                  "path" : "url"
                }
              ],
              "ordered" : false,
              "rules" : "open"
            },
            "short" : "Extension",
            "definition" : "An Extension",
            "min" : 1,
            "max" : "*",
            "base" : {
              "path" : "DomainResource.extension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : false,
            "isSummary" : false
          },
          {
            "id" : "Communication.extension:event-recorded",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.extension",
            "sliceName" : "event-recorded",
            "short" : "(QI) Captures the recorded date of the communication",
            "definition" : "Captures the recorded date of the event.",
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "DomainResource.extension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension",
                "profile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/event-recorded"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : false,
            "isSummary" : false
          },
          {
            "id" : "Communication.modifierExtension",
            "path" : "Communication.modifierExtension",
            "short" : "Extensions that cannot be ignored",
            "definition" : "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
            "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
            "requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
            "alias" : [
              "extensions",
              "user content"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "DomainResource.modifierExtension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : true,
            "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "N/A"
              }
            ]
          },
          {
            "id" : "Communication.identifier",
            "path" : "Communication.identifier",
            "short" : "Unique identifier",
            "definition" : "Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.",
            "comment" : "This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number.",
            "requirements" : "Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.identifier",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Identifier"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.identifier"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.identifier"
              }
            ]
          },
          {
            "id" : "Communication.instantiatesCanonical",
            "path" : "Communication.instantiatesCanonical",
            "short" : "Instantiates FHIR protocol or definition",
            "definition" : "The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.instantiatesCanonical",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "canonical",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/PlanDefinition|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/ActivityDefinition|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/Measure|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/OperationDefinition|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/Questionnaire|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.instantiatesCanonical"
              },
              {
                "identity" : "rim",
                "map" : ".outboundRelationship[typeCode=DEFN].target"
              }
            ]
          },
          {
            "id" : "Communication.instantiatesUri",
            "path" : "Communication.instantiatesUri",
            "short" : "Instantiates external protocol or definition",
            "definition" : "The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.",
            "comment" : "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.instantiatesUri",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "uri"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.instantiatesUri"
              },
              {
                "identity" : "rim",
                "map" : ".outboundRelationship[typeCode=DEFN].target"
              }
            ]
          },
          {
            "id" : "Communication.basedOn",
            "path" : "Communication.basedOn",
            "short" : "Request fulfilled by this communication",
            "definition" : "An order, proposal or plan fulfilled in whole or in part by this Communication.",
            "comment" : "This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.",
            "alias" : [
              "fulfills"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.basedOn",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.basedOn"
              }
            ]
          },
          {
            "id" : "Communication.partOf",
            "path" : "Communication.partOf",
            "short" : "Part of this action",
            "definition" : "Part of this action.",
            "alias" : [
              "container"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.partOf",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.partOf"
              }
            ]
          },
          {
            "id" : "Communication.inResponseTo",
            "path" : "Communication.inResponseTo",
            "short" : "Reply to",
            "definition" : "Prior communication that this communication is in response to.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.inResponseTo",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Communication|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false
          },
          {
            "id" : "Communication.status",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              },
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.status",
            "short" : "(QI) not-done",
            "definition" : "The status of the transmission.",
            "comment" : "This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.",
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "Communication.status",
              "min" : 1,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "code"
              }
            ],
            "fixedCode" : "not-done",
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : true,
            "isModifierReason" : "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
            "isSummary" : true,
            "binding" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                  "valueString" : "CommunicationStatus"
                }
              ],
              "strength" : "required",
              "description" : "The status of the communication.",
              "valueSet" : "http://hl7.org/fhir/ValueSet/event-status|4.0.1"
            },
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.status"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.status"
              }
            ]
          },
          {
            "id" : "Communication.statusReason",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.statusReason",
            "short" : "(QI) Reason for current status",
            "definition" : "Captures the reason for the current state of the Communication.",
            "comment" : "This is generally only used for \"exception\" statuses such as \"not-done\", \"suspended\" or \"aborted\". The reason for performing the event at all is captured in reasonCode, not here.",
            "alias" : [
              "Suspended Reason",
              "Cancelled Reason"
            ],
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "Communication.statusReason",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "binding" : {
              "strength" : "extensible",
              "valueSet" : "http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason"
            },
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.statusReason"
              }
            ]
          },
          {
            "id" : "Communication.category",
            "path" : "Communication.category",
            "short" : "Message category",
            "definition" : "The type of message conveyed such as alert, notification, reminder, instruction, etc.",
            "comment" : "There may be multiple axes of categorization and one communication may serve multiple purposes.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.category",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "binding" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                  "valueString" : "CommunicationCategory"
                }
              ],
              "strength" : "example",
              "description" : "Codes for general categories of communications such as alerts, instructions, etc.",
              "valueSet" : "http://hl7.org/fhir/ValueSet/communication-category|4.0.1"
            },
            "mapping" : [
              {
                "identity" : "w5",
                "map" : "FiveWs.class"
              }
            ]
          },
          {
            "id" : "Communication.priority",
            "path" : "Communication.priority",
            "short" : "routine | urgent | asap | stat",
            "definition" : "Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.",
            "comment" : "Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.priority",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "code"
              }
            ],
            "meaningWhenMissing" : "If missing, this communication should be treated with normal priority",
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "binding" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                  "valueString" : "CommunicationPriority"
                }
              ],
              "strength" : "required",
              "description" : "Codes indicating the relative importance of a communication.",
              "valueSet" : "http://hl7.org/fhir/ValueSet/request-priority|4.0.1"
            },
            "mapping" : [
              {
                "identity" : "w5",
                "map" : "FiveWs.grade"
              }
            ]
          },
          {
            "id" : "Communication.medium",
            "path" : "Communication.medium",
            "short" : "A channel of communication",
            "definition" : "A channel that was used for this communication (e.g. email, fax).",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.medium",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "binding" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                  "valueString" : "CommunicationMedium"
                }
              ],
              "strength" : "example",
              "description" : "Codes for communication mediums such as phone, fax, email, in person, etc.",
              "valueSet" : "http://terminology.hl7.org/ValueSet/v3-ParticipationMode"
            }
          },
          {
            "id" : "Communication.subject",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.subject",
            "short" : "(QI) Focus of message",
            "definition" : "The patient or group that was the focus of this communication.",
            "alias" : [
              "patient"
            ],
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.subject",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/Group"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.subject"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.subject[x]"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.subject"
              }
            ]
          },
          {
            "id" : "Communication.topic",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.topic",
            "short" : "(QI) Description of the purpose/content",
            "definition" : "Description of the purpose/content, similar to a subject line in an email.",
            "comment" : "Communication.topic.text can be used without any codings.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.topic",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ],
            "condition" : [
              "com-1"
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "binding" : {
              "strength" : "preferred",
              "valueSet" : "http://terminology.hl7.org/ValueSet/communication-topic|1.0.0"
            },
            "mapping" : [
              {
                "identity" : "w5",
                "map" : "FiveWs.context"
              }
            ]
          },
          {
            "id" : "Communication.topic.id",
            "path" : "Communication.topic.id",
            "representation" : [
              "xmlAttr"
            ],
            "short" : "Unique id for inter-element referencing",
            "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Element.id",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                    "valueUrl" : "string"
                  }
                ],
                "code" : "http://hl7.org/fhirpath/System.String"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "n/a"
              }
            ]
          },
          {
            "id" : "Communication.topic.extension",
            "path" : "Communication.topic.extension",
            "slicing" : {
              "discriminator" : [
                {
                  "type" : "value",
                  "path" : "url"
                }
              ],
              "description" : "Extensions are always sliced by (at least) url",
              "rules" : "open"
            },
            "short" : "Additional content defined by implementations",
            "definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
            "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
            "alias" : [
              "extensions",
              "user content"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Element.extension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "n/a"
              }
            ]
          },
          {
            "id" : "Communication.topic.extension:codeOptions",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.topic.extension",
            "sliceName" : "codeOptions",
            "short" : "(QI) Url of a value set of candidate topics",
            "definition" : "A logical reference (e.g. a reference to ValueSet.url) to a value set/version that identifies a set of possible coded values representing the purpose or content of the communication.",
            "comment" : "This extension SHALL NOT be used when an appropriate higher level concept code exists. When this extension is used on an element with a required binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set. When used with an extensible binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set unless none of the codes in the bound value set apply to the concept being communicated (based on human review). When this extension appears on a CodeableConcept, the CodeableConcept SHALL have no codings, and the text of the CodeableConcept SHALL include the title of the referenced value set.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Element.extension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension",
                "profile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/codeOptions|7.0.2"
                ]
              }
            ],
            "condition" : [
              "com-1"
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "v2",
                "map" : "CWE."
              },
              {
                "identity" : "rim",
                "map" : "CD.valueSet/CD.valueSetVersion"
              }
            ]
          },
          {
            "id" : "Communication.topic.coding",
            "path" : "Communication.topic.coding",
            "short" : "Code defined by a terminology system",
            "definition" : "A reference to a code defined by a terminology system.",
            "comment" : "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
            "requirements" : "Allows for alternative encodings within a code system, and translations to other code systems.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "CodeableConcept.coding",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Coding"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "v2",
                "map" : "C*E.1-8, C*E.10-22"
              },
              {
                "identity" : "rim",
                "map" : "union(., ./translation)"
              },
              {
                "identity" : "orim",
                "map" : "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
              }
            ]
          },
          {
            "id" : "Communication.topic.text",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.topic.text",
            "short" : "Plain text representation of the concept",
            "definition" : "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
            "comment" : "Very often the text is the same as a displayName of one of the codings.",
            "requirements" : "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "CodeableConcept.text",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "string"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "v2",
                "map" : "C*E.9. But note many systems use C*E.2 for this"
              },
              {
                "identity" : "rim",
                "map" : "./originalText[mediaType/code=\"text/plain\"]/data"
              },
              {
                "identity" : "orim",
                "map" : "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
              }
            ]
          },
          {
            "id" : "Communication.about",
            "path" : "Communication.about",
            "short" : "Resources that pertain to this communication",
            "definition" : "Other resources that pertain to this communication and to which this communication should be associated.",
            "comment" : "Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.about",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "w5",
                "map" : "FiveWs.context"
              }
            ]
          },
          {
            "id" : "Communication.encounter",
            "path" : "Communication.encounter",
            "short" : "Encounter created as part of",
            "definition" : "The Encounter during which this Communication was created or to which the creation of this record is tightly associated.",
            "comment" : "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.encounter",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Encounter|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.context"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.context"
              }
            ]
          },
          {
            "id" : "Communication.sent",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.sent",
            "short" : "(QI) When sent",
            "definition" : "The time when this communication was sent.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.sent",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "dateTime"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.occurrence[x] {Invariant: maps to period.start}"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.done[x]"
              }
            ]
          },
          {
            "id" : "Communication.received",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.received",
            "short" : "(QI) When received",
            "definition" : "The time when this communication arrived at the destination.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.received",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "dateTime"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.occurrence[x] {Invariant: maps to period.end}"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.done[x]"
              }
            ]
          },
          {
            "id" : "Communication.recipient",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.recipient",
            "short" : "(QI) Message recipient",
            "definition" : "The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.recipient",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-careteam"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"🔗 ,
                  "http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/Group"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.performer.actor"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.actor"
              }
            ]
          },
          {
            "id" : "Communication.sender",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.sender",
            "short" : "(QI) Message sender",
            "definition" : "The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Communication.sender",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"🔗 ,
                  "http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"🔗 ,
                  "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.performer.actor"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.actor"
              }
            ]
          },
          {
            "id" : "Communication.reasonCode",
            "path" : "Communication.reasonCode",
            "short" : "Indication for message",
            "definition" : "The reason or justification for the communication.",
            "comment" : "Textual reasons can be captured using reasonCode.text.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.reasonCode",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "binding" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                  "valueString" : "CommunicationReason"
                }
              ],
              "strength" : "example",
              "description" : "Codes for describing reasons for the occurrence of a communication.",
              "valueSet" : "http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1"
            },
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.reasonCode"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.why[x]"
              },
              {
                "identity" : "rim",
                "map" : ".reasonCode"
              }
            ]
          },
          {
            "id" : "Communication.reasonReference",
            "path" : "Communication.reasonReference",
            "short" : "Why was communication done?",
            "definition" : "Indicates another resource whose existence justifies this communication.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.reasonReference",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Condition|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/Observation|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/DiagnosticReport|4.0.1"🔗 ,
                  "http://hl7.org/fhir/StructureDefinition/DocumentReference|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.reasonReference"
              },
              {
                "identity" : "w5",
                "map" : "FiveWs.why[x]"
              },
              {
                "identity" : "rim",
                "map" : ".outboundRelationship[typeCode=RSON].target"
              }
            ]
          },
          {
            "id" : "Communication.payload",
            "path" : "Communication.payload",
            "short" : "Message payload",
            "definition" : "Text, attachment(s), or resource(s) that was communicated to the recipient.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.payload",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "BackboneElement"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false
          },
          {
            "id" : "Communication.payload.id",
            "path" : "Communication.payload.id",
            "representation" : [
              "xmlAttr"
            ],
            "short" : "Unique id for inter-element referencing",
            "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Element.id",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                    "valueUrl" : "string"
                  }
                ],
                "code" : "http://hl7.org/fhirpath/System.String"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "n/a"
              }
            ]
          },
          {
            "id" : "Communication.payload.extension",
            "path" : "Communication.payload.extension",
            "short" : "Additional content defined by implementations",
            "definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
            "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
            "alias" : [
              "extensions",
              "user content"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Element.extension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "n/a"
              }
            ]
          },
          {
            "id" : "Communication.payload.modifierExtension",
            "path" : "Communication.payload.modifierExtension",
            "short" : "Extensions that cannot be ignored even if unrecognized",
            "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
            "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
            "requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
            "alias" : [
              "extensions",
              "user content",
              "modifiers"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "BackboneElement.modifierExtension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : true,
            "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "N/A"
              }
            ]
          },
          {
            "id" : "Communication.payload.content[x]",
            "path" : "Communication.payload.content[x]",
            "short" : "Message part content",
            "definition" : "A communicated content (or for multi-part communications, one portion of the communication).",
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "Communication.payload.content[x]",
              "min" : 1,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "string"
              },
              {
                "code" : "Attachment"
              },
              {
                "code" : "Reference",
                "targetProfile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"
                ]
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false
          },
          {
            "id" : "Communication.note",
            "path" : "Communication.note",
            "short" : "Comments made about the communication",
            "definition" : "Additional notes or commentary about the communication by the sender, receiver or other interested parties.",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Communication.note",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Annotation"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "workflow",
                "map" : "Event.note"
              }
            ]
          }
        ]
      },
      "differential" : {
        "element" : [
          {
            "id" : "Communication",
            "path" : "Communication",
            "mustSupport" : false
          },
          {
            "id" : "Communication.extension:event-recorded",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.extension",
            "sliceName" : "event-recorded",
            "short" : "(QI) Captures the recorded date of the communication",
            "min" : 1,
            "max" : "1",
            "type" : [
              {
                "code" : "Extension",
                "profile" : [
                  🔗 "http://hl7.org/fhir/StructureDefinition/event-recorded"
                ]
              }
            ]
          },
          {
            "id" : "Communication.status",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.status",
            "short" : "(QI) not-done",
            "min" : 1,
            "max" : "1",
            "type" : [
              {
                "code" : "code"
              }
            ],
            "fixedCode" : "not-done"
          },
          {
            "id" : "Communication.statusReason",
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
                "valueBoolean" : true
              }
            ],
            "path" : "Communication.statusReason",
            "short" : "(QI) Reason for current status",
            "min" : 1,
            "max" : "1",
            "binding" : {
              "strength" : "extensible",
              "valueSet" : "http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason"
            }
          }
        ]
      }
    }