<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="qicore-imagingstudy"/>
  <text>
    <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml"><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 : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" 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 : 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-imagingstudy-definitions.html#ImagingStudy">ImagingStudy</a><a name="ImagingStudy"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : 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 : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/imagingstudy.html">ImagingStudy</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A set of images produced in single study (one or more series of references images)</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : 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_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-imagingstudy-definitions.html#ImagingStudy.subject">subject</a><a name="ImagingStudy.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-qicore-patient.html">QICorePatient</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Who or what is the subject of the study</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; 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_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-qicore-imagingstudy-definitions.html#ImagingStudy.started">started</a><a name="ImagingStudy.started"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : 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">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">When the study was started</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : 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_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-imagingstudy-definitions.html#ImagingStudy.basedOn">basedOn</a><a name="ImagingStudy.basedOn"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; 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 : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a> | <a href="http://hl7.org/fhir/R4/careplan.html">CarePlan</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Request fulfilled</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; 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_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-imagingstudy-definitions.html#ImagingStudy.referrer">referrer</a><a name="ImagingStudy.referrer"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : 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">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-qicore-practitioner.html">QICorePractitioner</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Referring physician</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : 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_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-imagingstudy-definitions.html#ImagingStudy.interpreter">interpreter</a><a name="ImagingStudy.interpreter"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; 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 : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-qicore-practitioner.html">QICorePractitioner</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Who interpreted images</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : 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_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-imagingstudy-definitions.html#ImagingStudy.procedureReference">procedureReference</a><a name="ImagingStudy.procedureReference"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : 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">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">The performed Procedure reference</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-imagingstudy"/>
  <version value="4.1.0"/>
  <name value="QICoreImagingStudy"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2018-08-22"/>
  <publisher value="http://www.hl7.org/Special/committees/cqi/index.cfm"/>
  <contact>
    <name value="Clinical Quality Information WG"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description value="Profile of ImagingStudy for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="dicom"/>
    <uri value="http://nema.org/dicom"/>
    <name value="DICOM Tag Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="ImagingStudy"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="ImagingStudy">
      <path value="ImagingStudy"/>
      <short value="A set of images produced in single study (one or more series of references images)"/>
      <definition value="Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context.  A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human value="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 value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="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."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act[classCode=COMPOSITION, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="Reference IHE radiology TF vol 2 table 4.14-1"/>
      </mapping>
    </element>
    <element id="ImagingStudy.id">
      <path value="ImagingStudy.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment value="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 value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="ImagingStudy.meta">
      <path value="ImagingStudy.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="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 value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="ImagingStudy.implicitRules">
      <path value="ImagingStudy.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="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 value="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&#39;s narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="ImagingStudy.language">
      <path value="ImagingStudy.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment value="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 value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="ImagingStudy.text">
      <path value="ImagingStudy.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="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 &quot;clinically safe&quot; 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 value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="ImagingStudy.contained">
      <path value="ImagingStudy.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="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 value="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 value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.extension">
      <path value="ImagingStudy.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.modifierExtension">
      <path value="ImagingStudy.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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&#39;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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.identifier">
      <path value="ImagingStudy.identifier"/>
      <short value="Identifiers for the whole study"/>
      <definition value="Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number."/>
      <comment value="See discussion under [Imaging Study Implementation Notes](http://hl7.org/fhir/R4/imagingstudy.html#notes) for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type."/>
      <requirements value="If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see [DICOM PS 3.3 C.7.2](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.2.html)."/>
      <alias value="StudyInstanceUID"/>
      <alias value="AccessionNumber"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id and .inboundRelationship[typeCode=COMP].source[classCode=ACSN, moodCode=EVN].id"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="StudyInstanceUID (0020,000D) | Accession Number and Issuer (0080,0050)+(0080,0051) | Study ID (0020,0010)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.status">
      <path value="ImagingStudy.status"/>
      <short value="registered | available | cancelled | entered-in-error | unknown"/>
      <definition value="The current state of the ImagingStudy."/>
      <comment value="Unknown does not represent &quot;other&quot; - one of the defined statuses must apply.  Unknown is used when the authoring system is not sure what the current status is."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason value="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 value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingStudyStatus"/>
        </extension>
        <strength value="required"/>
        <description value="The status of the ImagingStudy."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="Varies by domain"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".status"/>
      </mapping>
    </element>
    <element id="ImagingStudy.modality">
      <path value="ImagingStudy.modality"/>
      <short value="All series modality if actual acquisition modalities"/>
      <definition value="A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19)."/>
      <alias value="ModalitiesInStudy"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.modality"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingModality"/>
        </extension>
        <strength value="extensible"/>
        <description value="Type of acquired data in the instance."/>
        <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0061)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.subject">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="dicom=http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.2.2.html"/>
      </extension>
      <path value="ImagingStudy.subject"/>
      <short value="Who or what is the subject of the study"/>
      <definition value="The subject, typically a patient, of the imaging study."/>
      <comment value="QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0010/*)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
    </element>
    <element id="ImagingStudy.encounter">
      <path value="ImagingStudy.encounter"/>
      <short value="Encounter with which this imaging study is associated"/>
      <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made."/>
      <comment value="This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.encounter"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.context"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.started">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="dicom=http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.2.html#sect_C.7.2.1"/>
      </extension>
      <path value="ImagingStudy.started"/>
      <short value="When the study was started"/>
      <definition value="Date and time the study started."/>
      <alias value="StudyDate"/>
      <alias value="StudyTime"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.started"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <example>
        <label value="General"/>
        <valueDateTime value="2011-01-01T11:01:20+03:00"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.init"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0020)+(0008,0030)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.basedOn">
      <path value="ImagingStudy.basedOn"/>
      <short value="Request fulfilled"/>
      <definition value="A list of the diagnostic requests that resulted in this imaging study being performed."/>
      <requirements value="To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.basedOn"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.cause"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0032,1064)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.referrer">
      <path value="ImagingStudy.referrer"/>
      <short value="Referring physician"/>
      <definition value="The requesting/referring physician."/>
      <alias value="ReferringPhysiciansName"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.referrer"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.cause"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO].participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0090)+(0008,0096)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.interpreter">
      <path value="ImagingStudy.interpreter"/>
      <short value="Who interpreted images"/>
      <definition value="Who read the study and interpreted the images or other content."/>
      <alias value="Name of Physician(s) Reading Study"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.interpreter"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.witness"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1060)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.endpoint">
      <path value="ImagingStudy.endpoint"/>
      <short value="Study access endpoint"/>
      <definition value="The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType."/>
      <comment value="Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer."/>
      <requirements value="Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.endpoint"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Endpoint"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Not supported"/>
      </mapping>
    </element>
    <element id="ImagingStudy.numberOfSeries">
      <path value="ImagingStudy.numberOfSeries"/>
      <short value="Number of Study Related Series"/>
      <definition value="Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present."/>
      <alias value="NumberOfStudyRelatedSeries"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.numberOfSeries"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=OBSSER, moodCode=EVN].repeatNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,1206)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.numberOfInstances">
      <path value="ImagingStudy.numberOfInstances"/>
      <short value="Number of Study Related Instances"/>
      <definition value="Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present."/>
      <alias value="NumberOfStudyRelatedInstances"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.numberOfInstances"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,1208)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.procedureReference">
      <path value="ImagingStudy.procedureReference"/>
      <short value="The performed Procedure reference"/>
      <definition value="The procedure which this ImagingStudy was part of."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.procedureReference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.partOf"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1032)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.procedureCode">
      <path value="ImagingStudy.procedureCode"/>
      <short value="The performed procedure code"/>
      <definition value="The code for the performed procedure type."/>
      <alias value="ProcedureCodeSequence"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.procedureCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingProcedureCode"/>
        </extension>
        <strength value="extensible"/>
        <description value="The performed procedure type."/>
        <valueSet value="http://www.rsna.org/RadLex_Playbook.aspx"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1032)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.location">
      <path value="ImagingStudy.location"/>
      <short value="Where ImagingStudy occurred"/>
      <definition value="The principal physical location where the ImagingStudy was performed."/>
      <requirements value="Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.location"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.where[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="EVN.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=LOC].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1040) | (0040,0243)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.reasonCode">
      <path value="ImagingStudy.reasonCode"/>
      <short value="Why the study was requested"/>
      <definition value="Description of clinical condition indicating why the ImagingStudy was requested."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.reasonCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingReason"/>
        </extension>
        <strength value="example"/>
        <description value="The reason for the study."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/procedure-reason"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0040,1002)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.reasonReference">
      <path value="ImagingStudy.reasonReference"/>
      <short value="Why was study performed"/>
      <definition value="Indicates another resource whose existence justifies this Study."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.reasonReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonReference"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="EVN.4 or by domain"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=RSON].target"/>
      </mapping>
    </element>
    <element id="ImagingStudy.note">
      <path value="ImagingStudy.note"/>
      <short value="User-defined comments"/>
      <definition value="Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.note"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unknown"/>
      </mapping>
    </element>
    <element id="ImagingStudy.description">
      <path value="ImagingStudy.description"/>
      <short value="Institution-generated description"/>
      <definition value="The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed."/>
      <alias value="StudyDescription"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1030)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series">
      <path value="ImagingStudy.series"/>
      <short value="Each study has one or more series of instances"/>
      <definition value="Each study has one or more series of images or other content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBSSER, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.id">
      <path value="ImagingStudy.series.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.extension">
      <path value="ImagingStudy.series.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.modifierExtension">
      <path value="ImagingStudy.series.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition value="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&#39;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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.uid">
      <path value="ImagingStudy.series.uid"/>
      <short value="DICOM Series Instance UID for the series"/>
      <definition value="The DICOM Series Instance UID for the series."/>
      <comment value="See [DICOM PS3.3 C.7.3](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.3.html)."/>
      <requirements value="DICOM Series Instance UID."/>
      <alias value="SeriesInstanceUID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.uid"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <example>
        <label value="General"/>
        <valueId value="2.16.124.113543.6003.2588828330.45298.17418.2723805630"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,000E)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.number">
      <path value="ImagingStudy.series.number"/>
      <short value="Numeric identifier of this series"/>
      <definition value="The numeric identifier of this series in the study."/>
      <alias value="SeriesNumber"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.number"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <example>
        <label value="General"/>
        <valueUnsignedInt value="3"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[type=COMP, source[classCode=COMPOSITION, moodCode=EVN]].sequenceNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,0011)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.modality">
      <path value="ImagingStudy.series.modality"/>
      <short value="The modality of the instances in the series"/>
      <definition value="The modality of this series sequence."/>
      <alias value="Modality"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.modality"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingModality"/>
        </extension>
        <strength value="extensible"/>
        <description value="Type of acquired data in the instance."/>
        <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0060)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.description">
      <path value="ImagingStudy.series.description"/>
      <short value="A short human readable summary of the series"/>
      <definition value="A description of the series."/>
      <alias value="SeriesDescription"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <example>
        <label value="General"/>
        <valueString value="CT Surview 180"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,103E)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.numberOfInstances">
      <path value="ImagingStudy.series.numberOfInstances"/>
      <short value="Number of Series Related Instances"/>
      <definition value="Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present."/>
      <alias value="NumberOfSeriesRelatedInstances"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.numberOfInstances"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,1209)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.endpoint">
      <path value="ImagingStudy.series.endpoint"/>
      <short value="Series access endpoint"/>
      <definition value="The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType."/>
      <comment value="Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances."/>
      <requirements value="Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.endpoint"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Endpoint"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Not supported"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.bodySite">
      <path value="ImagingStudy.series.bodySite"/>
      <short value="Body part examined"/>
      <definition value="The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality."/>
      <alias value="BodyPartExamined"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.bodySite"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/>
        </extension>
        <strength value="example"/>
        <description value="Codes describing anatomical locations. May include laterality."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0018,0015)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.laterality">
      <path value="ImagingStudy.series.laterality"/>
      <short value="Body part laterality"/>
      <definition value="The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.laterality"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Laterality"/>
        </extension>
        <strength value="example"/>
        <description value="Codes describing body site laterality (left, right, etc.)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/bodysite-laterality"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,0060)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.specimen">
      <path value="ImagingStudy.series.specimen"/>
      <short value="Specimen imaged"/>
      <definition value="The specimen imaged, e.g., for whole slide imaging of a biopsy."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Role[classCode=SPEC]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0040,0551) + (0040,0562)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.started">
      <path value="ImagingStudy.series.started"/>
      <short value="When the series started"/>
      <definition value="The date and time the series was started."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.started"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0021) + (0008,0031)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer">
      <path value="ImagingStudy.series.performer"/>
      <short value="Who performed the series"/>
      <definition value="Indicates who or what performed the series and how they were involved."/>
      <comment value="If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images."/>
      <requirements value="The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers."/>
      <alias value="PerformingPhysicianName"/>
      <alias value="OperatorName"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008, 1050) | (0008, 1052) | (0008, 1070) | (0008, 1072)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.id">
      <path value="ImagingStudy.series.performer.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.extension">
      <path value="ImagingStudy.series.performer.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.modifierExtension">
      <path value="ImagingStudy.series.performer.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition value="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&#39;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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.function">
      <path value="ImagingStudy.series.performer.function"/>
      <short value="Type of performance"/>
      <definition value="Distinguishes the type of involvement of the performer in the series."/>
      <requirements value="Allows disambiguation of the types of involvement of different performers."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.performer.function"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="EventPerformerFunction"/>
        </extension>
        <strength value="extensible"/>
        <description value="The type of involvement of the performer."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/series-performer-function"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.actor">
      <path value="ImagingStudy.series.performer.actor"/>
      <short value="Who performed the series"/>
      <definition value="Indicates who or what performed the series."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.performer.actor"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="EVN.5 or by domain"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance">
      <path value="ImagingStudy.series.instance"/>
      <short value="A single SOP instance from the series"/>
      <definition value="A single SOP instance within the series, e.g. an image, or presentation state."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.instance"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=DGIMG, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.id">
      <path value="ImagingStudy.series.instance.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.extension">
      <path value="ImagingStudy.series.instance.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.modifierExtension">
      <path value="ImagingStudy.series.instance.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition value="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&#39;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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment value="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 value="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 value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.uid">
      <path value="ImagingStudy.series.instance.uid"/>
      <short value="DICOM SOP Instance UID"/>
      <definition value="The DICOM SOP Instance UID for this image or other DICOM content."/>
      <comment value="See  [DICOM PS3.3 C.12.1](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.12.html#sect_C.12.1)."/>
      <requirements value="DICOM SOP Instance UID."/>
      <alias value="SOPInstanceUID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.uid"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <example>
        <label value="General"/>
        <valueId value="2.16.124.113543.6003.189642796.63084.16748.2599092903"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0018)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.sopClass">
      <path value="ImagingStudy.series.instance.sopClass"/>
      <short value="DICOM class type"/>
      <definition value="DICOM instance  type."/>
      <alias value="SOPClassUID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.sopClass"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="sopClass"/>
        </extension>
        <strength value="extensible"/>
        <description value="The sopClass for the instance."/>
        <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=COMP]. source[classCode=OBS, moodCode=EVN, code=&quot;sop class&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0016)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.number">
      <path value="ImagingStudy.series.instance.number"/>
      <short value="The number of this instance in the series"/>
      <definition value="The number of instance in the series."/>
      <alias value="InstanceNumber"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.number"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <example>
        <label value="General"/>
        <valueUnsignedInt value="1"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=COMP, source[classCode=OBSSER, moodCode=EVN]].sequenceNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,0013)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.title">
      <path value="ImagingStudy.series.instance.title"/>
      <short value="Description of instance"/>
      <definition value="The description of the instance."/>
      <comment value="Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.title"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".title"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0008) | (0007,0080) | (0040,A043) + (0008,0104) | (0042,0010)"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="ImagingStudy">
      <path value="ImagingStudy"/>
      <mustSupport value="false"/>
    </element>
    <element id="ImagingStudy.subject">
      <path value="ImagingStudy.subject"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="ImagingStudy.started">
      <path value="ImagingStudy.started"/>
      <mustSupport value="true"/>
    </element>
    <element id="ImagingStudy.basedOn">
      <path value="ImagingStudy.basedOn"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="ImagingStudy.referrer">
      <path value="ImagingStudy.referrer"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <mustSupport value="false"/>
    </element>
    <element id="ImagingStudy.interpreter">
      <path value="ImagingStudy.interpreter"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <mustSupport value="false"/>
    </element>
    <element id="ImagingStudy.procedureReference">
      <path value="ImagingStudy.procedureReference"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
      </type>
      <mustSupport value="true"/>
    </element>
  </differential>
</StructureDefinition>