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

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/pacio-adi/ and changes regularly. See the Directory of published versions

## Resource Profile: ADI PtAuthored Composition

Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PACPComposition | Version: 2.0.0-ballot
Standards status: Trial-use | Maturity Level: 2 | Computable Name: ADIPACPComposition

This profile encompasses information that makes up the author’s advance care information plan.

This profile defines the requirements for communicating a Personal Advance Care Plan (PACP) using a Composition Resource. It is used to create a person-generated document which is authored by the subject of the document (the patient). It contains information about the person's goals, preferences, and priorities (GPPs) for care and treatment under certain future conditions.

It is possible for a PACP composition to only contain textual information and not have any encoded entries. In this case, an implementer may populate the `section.text` element in place of a resource reference in the `section.entry` element.

For a Patient-authored composition, the attester is set to personal.

Usages:

- Use this Profile: ADI Bundle
- Examples for this Profile: Composition/Example-Smith-Johnson-PACPComposition1 and Composition/MHAD-Example-Smith-Johnson-Composition
- CapabilityStatements using this Profile: ADI CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition | C | 0..* | ADICompositionHeader | A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language | S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  |  |  | Content/Rules for all slices
extension:versionNumber |  | 0..* | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
extension:ExpirationDateExtension |  | 0..1 | dateTime | ADI Expiration Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
extension:Jurisdiction |  | 0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
extension:DataEntererExtension |  | 0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
extension:InformantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
extension:ParticipantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
extension:PerformerExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
extension:DocumentRevokeStatus | S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | Version-independent identifier for the Composition
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required)
type | S Σ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Healthcare Directive Categories LOINC (extensible)
category | S Σ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3
display |  | 1..1 | string | Representation defined by the system Fixed Value: Advance healthcare directives
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about
date | S Σ | 1..1 | dateTime | Composition editing time
author | S Σ | 1..* | Reference(US Core Patient Profile) | Who and/or what authored the composition
title | S Σ | 1..1 | string | Human Readable name/title
attester | S | 1..* | BackboneElement | Attests to accuracy of composition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: personal
party |  | 0..1 | Reference(US Core Patient Profile | RelatedPerson) | Who attested the composition
custodian | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
section:healthcare_agent | S C | 1..1 | BackboneElement | Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: cmp-1, cmp-2, HCA-section-entries
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81335-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
section:gpp_for_certain_health_condition | C | 0..1 | BackboneElement | Preference care plans defined for specific situations and/or conditions Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81336-0
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI PtAuthored Care Plan) | A reference to data that supports this section
section:gpp_personal_care_experience | C | 0..1 | BackboneElement | Quality of Life related personal care experiences, personal goals, and priorities Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81338-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI PtAuthored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) | A reference to data that supports this section
section:gpp_upon_death | C | 0..1 | BackboneElement | Goals, preferences, and priorities upon death Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81337-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI PtAuthored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal | ADI Upon Death Preferences) | A reference to data that supports this section
section:minimal_source_form | C | 0..1 | BackboneElement | Minimal source form Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code | S | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: minimal_source_form
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Minimal Source Form) | A reference to data that supports this section
section:additional_documentation | C | 0..1 | BackboneElement | Observations regarding the existence of other advance directive related information Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Documentation Observation) | A reference to data that supports this section
section:witness_and_notary | C | 0..1 | BackboneElement | Witness and notary information. The first witness should be the author of the document Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81339-4
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Witness | ADI Notary) | A reference to data that supports this section
section:administrative_information | C | 0..1 | BackboneElement | Administrative information associated with this personal advance care plan Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81381-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Composition.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Composition.status | required | ADICompositionStatusVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS` From this IG
Composition.type | extensible | AdvanceHealthcareDirectiveCategoriesLOINC `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4` From https://vsac.nlm.nih.gov
Composition.category | example | Pattern Value: LOINC Code 42348-3("Advance healthcare directives") `http://hl7.org/fhir/ValueSet/document-classcodes` From the FHIR Standard
Composition.attester.mode | required | Pattern Value: personal `http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1` From the FHIR Standard
Composition.section:healthcare_agent.code | example | Pattern Value: LOINC Code 81335-2 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:healthcare_agent.emptyReason | required | ADINoHealthcareAgentIncludedReasonVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS` From this IG
Composition.section:gpp_for_certain_health_condition.code | example | Pattern Value: LOINC Code 81336-0 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_personal_care_experience.code | example | Pattern Value: LOINC Code 81338-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_upon_death.code | example | Pattern Value: LOINC Code 81337-8 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:minimal_source_form.code | example | Pattern Value: minimal_source_form `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:additional_documentation.code | example | Pattern Value: LOINC Code 77599-9 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:witness_and_notary.code | example | Pattern Value: LOINC Code 81339-4 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:administrative_information.code | example | Pattern Value: LOINC Code 81381-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
Composition-section-code-equals-type | error | Composition | Composition section code must equal Composition type when section is portable_medical_orders : section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type |
HCA-section-cardinality | error | Composition | If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent) : (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1 |
HCA-section-emptyReason-required | error | Composition | section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries. : section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists() |
HCA-section-entries | error | Composition.section:healthcare_agent | If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist : entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists()) |
cmp-1 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists() |
cmp-2 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty() |
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Composition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Composition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from ADICompositionHeader

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition | C | 0..* | ADICompositionHeader | A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
author |  | 1..* | Reference(US Core Patient Profile) | Who and/or what authored the composition
attester | S | 1..* | BackboneElement | Attests to accuracy of composition
mode |  | 1..1 | code | personal | professional | legal | official Required Pattern: personal
party |  | 0..1 | Reference(US Core Patient Profile | RelatedPerson) | Who attested the composition
Slices for section |  | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:code
section:All Slices |  |  |  | Content/Rules for all slices
text | S | 1..1 | Narrative | Text summary of the section, for human interpretation
section:healthcare_agent | S C | 1..1 | BackboneElement | Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: HCA-section-entries
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81335-2
entry |  | 0..* | Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) | A reference to data that supports this section
emptyReason |  | 0..1 | CodeableConcept | This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
section:gpp_for_certain_health_condition |  | 0..1 | BackboneElement | Preference care plans defined for specific situations and/or conditions
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81336-0
entry |  | 0..* | Reference(ADI PtAuthored Care Plan) | A reference to data that supports this section
section:gpp_personal_care_experience |  | 0..1 | BackboneElement | Quality of Life related personal care experiences, personal goals, and priorities
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81338-6
entry |  | 0..* | Reference(ADI PtAuthored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) | A reference to data that supports this section
section:gpp_upon_death |  | 0..1 | BackboneElement | Goals, preferences, and priorities upon death
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81337-8
entry |  | 0..* | Reference(ADI PtAuthored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal | ADI Upon Death Preferences) | A reference to data that supports this section
section:minimal_source_form |  | 0..1 | BackboneElement | Minimal source form
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code | S | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: minimal_source_form
entry |  | 0..* | Reference(ADI Minimal Source Form) | A reference to data that supports this section
section:additional_documentation |  | 0..1 | BackboneElement | Observations regarding the existence of other advance directive related information
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
entry |  | 0..* | Reference(ADI Documentation Observation) | A reference to data that supports this section
section:witness_and_notary |  | 0..1 | BackboneElement | Witness and notary information. The first witness should be the author of the document
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81339-4
entry |  | 0..* | Reference(ADI Witness | ADI Notary) | A reference to data that supports this section
section:administrative_information |  | 0..1 | BackboneElement | Administrative information associated with this personal advance care plan
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81381-6
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Composition.section:healthcare_agent.emptyReason | required | ADINoHealthcareAgentIncludedReasonVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
Composition-section-code-equals-type | error | Composition | Composition section code must equal Composition type when section is portable_medical_orders : section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type |
HCA-section-cardinality | error | Composition | If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent) : (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1 |
HCA-section-emptyReason-required | error | Composition | section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries. : section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists() |
HCA-section-entries | error | Composition.section:healthcare_agent | If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist : entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists()) |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition | C | 0..* | ADICompositionHeader | A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language | S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionNumber |  | 0..* | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
extension:ExpirationDateExtension |  | 0..1 | dateTime | ADI Expiration Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
extension:Jurisdiction |  | 0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
extension:DataEntererExtension |  | 0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
extension:InformantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
extension:ParticipantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
extension:PerformerExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
extension:DocumentRevokeStatus | S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | Version-independent identifier for the Composition
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required)
type | S Σ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Healthcare Directive Categories LOINC (extensible)
category | S Σ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3
display |  | 1..1 | string | Representation defined by the system Fixed Value: Advance healthcare directives
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(US Core Encounter Profile) | Context of the Composition
date | S Σ | 1..1 | dateTime | Composition editing time
author | S Σ | 1..* | Reference(US Core Patient Profile) | Who and/or what authored the composition
title | S Σ | 1..1 | string | Human Readable name/title
attester | S | 1..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: personal
time |  | 0..1 | dateTime | When the composition was attested
party |  | 0..1 | Reference(US Core Patient Profile | RelatedPerson) | Who attested the composition
custodian | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition
relatesTo |  | 0..* | BackboneElement | Relationships to other compositions/documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x] |  | 1..1 |  | Target of the relationship
targetIdentifier |  |  | Identifier |
targetReference |  |  | Reference(Composition) |
event | Σ | 0..* | BackboneElement | The clinical service(s) being documented
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acp-services
display |  | 1..1 | string | Representation defined by the system Fixed Value: Advance care planning services
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
period | Σ | 0..1 | Period | The period covered by the documentation
Slices for detail | Σ | 0..* | Reference(Resource) | The event(s) being documented Slice: Unordered, Open by profile:resolve()
detail:adiFacilitator | Σ | 0..1 | Reference(ADI Facilitator) | ADI Facilitator
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 0..1 | string | Label for section (e.g. for ToC)
code |  | 0..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:healthcare_agent | S C | 1..1 | BackboneElement | Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: cmp-1, cmp-2, HCA-section-entries
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81335-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
section | C | 0..* | See section (Composition) | Nested Section
section:gpp_for_certain_health_condition | C | 0..1 | BackboneElement | Preference care plans defined for specific situations and/or conditions Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81336-0
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI PtAuthored Care Plan) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:gpp_personal_care_experience | C | 0..1 | BackboneElement | Quality of Life related personal care experiences, personal goals, and priorities Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81338-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI PtAuthored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:gpp_upon_death | C | 0..1 | BackboneElement | Goals, preferences, and priorities upon death Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81337-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI PtAuthored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal | ADI Upon Death Preferences) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:minimal_source_form | C | 0..1 | BackboneElement | Minimal source form Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code | S | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: minimal_source_form
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Minimal Source Form) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:additional_documentation | C | 0..1 | BackboneElement | Observations regarding the existence of other advance directive related information Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Documentation Observation) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:witness_and_notary | C | 0..1 | BackboneElement | Witness and notary information. The first witness should be the author of the document Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81339-4
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Witness | ADI Notary) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:administrative_information | C | 0..1 | BackboneElement | Administrative information associated with this personal advance care plan Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81381-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Composition.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Composition.status | required | ADICompositionStatusVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS` From this IG
Composition.type | extensible | AdvanceHealthcareDirectiveCategoriesLOINC `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4` From https://vsac.nlm.nih.gov
Composition.category | example | Pattern Value: LOINC Code 42348-3("Advance healthcare directives") `http://hl7.org/fhir/ValueSet/document-classcodes` From the FHIR Standard
Composition.attester.mode | required | Pattern Value: personal `http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1` From the FHIR Standard
Composition.relatesTo.code | required | DocumentRelationshipType `http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1` From the FHIR Standard
Composition.event.code | example | Pattern Value: acp-services("Advance care planning services") `http://terminology.hl7.org/ValueSet/v3-ActCode`
Composition.section.code | example | DocumentSectionCodes `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:healthcare_agent.code | example | Pattern Value: LOINC Code 81335-2 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:healthcare_agent.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:healthcare_agent.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:healthcare_agent.emptyReason | required | ADINoHealthcareAgentIncludedReasonVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS` From this IG
Composition.section:gpp_for_certain_health_condition.code | example | Pattern Value: LOINC Code 81336-0 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_for_certain_health_condition.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:gpp_for_certain_health_condition.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:gpp_for_certain_health_condition.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:gpp_personal_care_experience.code | example | Pattern Value: LOINC Code 81338-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_personal_care_experience.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:gpp_personal_care_experience.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:gpp_personal_care_experience.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:gpp_upon_death.code | example | Pattern Value: LOINC Code 81337-8 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_upon_death.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:gpp_upon_death.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:gpp_upon_death.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:minimal_source_form.code | example | Pattern Value: minimal_source_form `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:minimal_source_form.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:minimal_source_form.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:minimal_source_form.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:additional_documentation.code | example | Pattern Value: LOINC Code 77599-9 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:additional_documentation.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:additional_documentation.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:additional_documentation.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:witness_and_notary.code | example | Pattern Value: LOINC Code 81339-4 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:witness_and_notary.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:witness_and_notary.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:witness_and_notary.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:administrative_information.code | example | Pattern Value: LOINC Code 81381-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:administrative_information.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:administrative_information.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:administrative_information.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
Composition-section-code-equals-type | error | Composition | Composition section code must equal Composition type when section is portable_medical_orders : section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type |
HCA-section-cardinality | error | Composition | If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent) : (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1 |
HCA-section-emptyReason-required | error | Composition | section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries. : section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists() |
HCA-section-entries | error | Composition.section:healthcare_agent | If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist : entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists()) |
cmp-1 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists() |
cmp-2 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty() |
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Composition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Composition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from ADICompositionHeader

Summary

Mandatory: 5 elements(15 nested mandatory elements)
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- ADI Healthcare Agent Consent (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentConsent)
- ADI Healthcare Agent Participant (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant)
- ADI PtAuthored Care Plan (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PreferenceCarePlan)
- ADI PtAuthored Care Experience Preference (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-CareExperiencePreference)
- ADI Personal Priorities Organizer (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalPrioritiesOrganizer)
- ADI Personal Goal (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalGoal)
- ADI PtAuthored Personal Intervention Preference (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalInterventionPreference)
- ADI Autopsy Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-AutopsyObservation)
- ADI Organ Donation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-OrganDonationObservation)
- ADI Upon Death Preferences (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-UponDeathPreferences)
- ADI Minimal Source Form (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIMinimalSourceFormInformation)
- ADI Documentation Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentationObservation)
- ADI Witness (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Witness)
- ADI Notary (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Notary)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.section

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition | C | 0..* | ADICompositionHeader | A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language | S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  |  |  | Content/Rules for all slices
extension:versionNumber |  | 0..* | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
extension:ExpirationDateExtension |  | 0..1 | dateTime | ADI Expiration Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
extension:Jurisdiction |  | 0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
extension:DataEntererExtension |  | 0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
extension:InformantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
extension:ParticipantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
extension:PerformerExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
extension:DocumentRevokeStatus | S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | Version-independent identifier for the Composition
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required)
type | S Σ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Healthcare Directive Categories LOINC (extensible)
category | S Σ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3
display |  | 1..1 | string | Representation defined by the system Fixed Value: Advance healthcare directives
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about
date | S Σ | 1..1 | dateTime | Composition editing time
author | S Σ | 1..* | Reference(US Core Patient Profile) | Who and/or what authored the composition
title | S Σ | 1..1 | string | Human Readable name/title
attester | S | 1..* | BackboneElement | Attests to accuracy of composition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: personal
party |  | 0..1 | Reference(US Core Patient Profile | RelatedPerson) | Who attested the composition
custodian | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
section:healthcare_agent | S C | 1..1 | BackboneElement | Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: cmp-1, cmp-2, HCA-section-entries
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81335-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
section:gpp_for_certain_health_condition | C | 0..1 | BackboneElement | Preference care plans defined for specific situations and/or conditions Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81336-0
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI PtAuthored Care Plan) | A reference to data that supports this section
section:gpp_personal_care_experience | C | 0..1 | BackboneElement | Quality of Life related personal care experiences, personal goals, and priorities Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81338-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI PtAuthored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) | A reference to data that supports this section
section:gpp_upon_death | C | 0..1 | BackboneElement | Goals, preferences, and priorities upon death Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81337-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI PtAuthored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal | ADI Upon Death Preferences) | A reference to data that supports this section
section:minimal_source_form | C | 0..1 | BackboneElement | Minimal source form Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code | S | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: minimal_source_form
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Minimal Source Form) | A reference to data that supports this section
section:additional_documentation | C | 0..1 | BackboneElement | Observations regarding the existence of other advance directive related information Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Documentation Observation) | A reference to data that supports this section
section:witness_and_notary | C | 0..1 | BackboneElement | Witness and notary information. The first witness should be the author of the document Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81339-4
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 0..* | Reference(ADI Witness | ADI Notary) | A reference to data that supports this section
section:administrative_information | C | 0..1 | BackboneElement | Administrative information associated with this personal advance care plan Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81381-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Composition.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Composition.status | required | ADICompositionStatusVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS` From this IG
Composition.type | extensible | AdvanceHealthcareDirectiveCategoriesLOINC `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4` From https://vsac.nlm.nih.gov
Composition.category | example | Pattern Value: LOINC Code 42348-3("Advance healthcare directives") `http://hl7.org/fhir/ValueSet/document-classcodes` From the FHIR Standard
Composition.attester.mode | required | Pattern Value: personal `http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1` From the FHIR Standard
Composition.section:healthcare_agent.code | example | Pattern Value: LOINC Code 81335-2 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:healthcare_agent.emptyReason | required | ADINoHealthcareAgentIncludedReasonVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS` From this IG
Composition.section:gpp_for_certain_health_condition.code | example | Pattern Value: LOINC Code 81336-0 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_personal_care_experience.code | example | Pattern Value: LOINC Code 81338-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_upon_death.code | example | Pattern Value: LOINC Code 81337-8 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:minimal_source_form.code | example | Pattern Value: minimal_source_form `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:additional_documentation.code | example | Pattern Value: LOINC Code 77599-9 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:witness_and_notary.code | example | Pattern Value: LOINC Code 81339-4 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:administrative_information.code | example | Pattern Value: LOINC Code 81381-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
Composition-section-code-equals-type | error | Composition | Composition section code must equal Composition type when section is portable_medical_orders : section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type |
HCA-section-cardinality | error | Composition | If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent) : (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1 |
HCA-section-emptyReason-required | error | Composition | section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries. : section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists() |
HCA-section-entries | error | Composition.section:healthcare_agent | If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist : entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists()) |
cmp-1 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists() |
cmp-2 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty() |
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Composition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Composition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Differential View

This structure is derived from ADICompositionHeader

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition | C | 0..* | ADICompositionHeader | A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
author |  | 1..* | Reference(US Core Patient Profile) | Who and/or what authored the composition
attester | S | 1..* | BackboneElement | Attests to accuracy of composition
mode |  | 1..1 | code | personal | professional | legal | official Required Pattern: personal
party |  | 0..1 | Reference(US Core Patient Profile | RelatedPerson) | Who attested the composition
Slices for section |  | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:code
section:All Slices |  |  |  | Content/Rules for all slices
text | S | 1..1 | Narrative | Text summary of the section, for human interpretation
section:healthcare_agent | S C | 1..1 | BackboneElement | Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: HCA-section-entries
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81335-2
entry |  | 0..* | Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) | A reference to data that supports this section
emptyReason |  | 0..1 | CodeableConcept | This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
section:gpp_for_certain_health_condition |  | 0..1 | BackboneElement | Preference care plans defined for specific situations and/or conditions
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81336-0
entry |  | 0..* | Reference(ADI PtAuthored Care Plan) | A reference to data that supports this section
section:gpp_personal_care_experience |  | 0..1 | BackboneElement | Quality of Life related personal care experiences, personal goals, and priorities
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81338-6
entry |  | 0..* | Reference(ADI PtAuthored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) | A reference to data that supports this section
section:gpp_upon_death |  | 0..1 | BackboneElement | Goals, preferences, and priorities upon death
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81337-8
entry |  | 0..* | Reference(ADI PtAuthored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal | ADI Upon Death Preferences) | A reference to data that supports this section
section:minimal_source_form |  | 0..1 | BackboneElement | Minimal source form
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code | S | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: minimal_source_form
entry |  | 0..* | Reference(ADI Minimal Source Form) | A reference to data that supports this section
section:additional_documentation |  | 0..1 | BackboneElement | Observations regarding the existence of other advance directive related information
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
entry |  | 0..* | Reference(ADI Documentation Observation) | A reference to data that supports this section
section:witness_and_notary |  | 0..1 | BackboneElement | Witness and notary information. The first witness should be the author of the document
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81339-4
entry |  | 0..* | Reference(ADI Witness | ADI Notary) | A reference to data that supports this section
section:administrative_information |  | 0..1 | BackboneElement | Administrative information associated with this personal advance care plan
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | ClauseExtension | Clause
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81381-6
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Composition.section:healthcare_agent.emptyReason | required | ADINoHealthcareAgentIncludedReasonVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
Composition-section-code-equals-type | error | Composition | Composition section code must equal Composition type when section is portable_medical_orders : section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type |
HCA-section-cardinality | error | Composition | If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent) : (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1 |
HCA-section-emptyReason-required | error | Composition | section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries. : section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists() |
HCA-section-entries | error | Composition.section:healthcare_agent | If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist : entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists()) |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition | C | 0..* | ADICompositionHeader | A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language | S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionNumber |  | 0..* | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
extension:ExpirationDateExtension |  | 0..1 | dateTime | ADI Expiration Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension
extension:Jurisdiction |  | 0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction.
extension:DataEntererExtension |  | 0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension
extension:InformantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension
extension:ParticipantExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension
extension:PerformerExtension |  | 0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
extension:DocumentRevokeStatus | S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | Version-independent identifier for the Composition
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required)
type | S Σ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Healthcare Directive Categories LOINC (extensible)
category | S Σ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3
display |  | 1..1 | string | Representation defined by the system Fixed Value: Advance healthcare directives
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(US Core Encounter Profile) | Context of the Composition
date | S Σ | 1..1 | dateTime | Composition editing time
author | S Σ | 1..* | Reference(US Core Patient Profile) | Who and/or what authored the composition
title | S Σ | 1..1 | string | Human Readable name/title
attester | S | 1..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: personal
time |  | 0..1 | dateTime | When the composition was attested
party |  | 0..1 | Reference(US Core Patient Profile | RelatedPerson) | Who attested the composition
custodian | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition
relatesTo |  | 0..* | BackboneElement | Relationships to other compositions/documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x] |  | 1..1 |  | Target of the relationship
targetIdentifier |  |  | Identifier |
targetReference |  |  | Reference(Composition) |
event | Σ | 0..* | BackboneElement | The clinical service(s) being documented
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acp-services
display |  | 1..1 | string | Representation defined by the system Fixed Value: Advance care planning services
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
period | Σ | 0..1 | Period | The period covered by the documentation
Slices for detail | Σ | 0..* | Reference(Resource) | The event(s) being documented Slice: Unordered, Open by profile:resolve()
detail:adiFacilitator | Σ | 0..1 | Reference(ADI Facilitator) | ADI Facilitator
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 0..1 | string | Label for section (e.g. for ToC)
code |  | 0..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:healthcare_agent | S C | 1..1 | BackboneElement | Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: cmp-1, cmp-2, HCA-section-entries
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81335-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
section | C | 0..* | See section (Composition) | Nested Section
section:gpp_for_certain_health_condition | C | 0..1 | BackboneElement | Preference care plans defined for specific situations and/or conditions Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81336-0
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI PtAuthored Care Plan) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:gpp_personal_care_experience | C | 0..1 | BackboneElement | Quality of Life related personal care experiences, personal goals, and priorities Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81338-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI PtAuthored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:gpp_upon_death | C | 0..1 | BackboneElement | Goals, preferences, and priorities upon death Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81337-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI PtAuthored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal | ADI Upon Death Preferences) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:minimal_source_form | C | 0..1 | BackboneElement | Minimal source form Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code | S | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: minimal_source_form
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Minimal Source Form) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:additional_documentation | C | 0..1 | BackboneElement | Observations regarding the existence of other advance directive related information Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Documentation Observation) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:witness_and_notary | C | 0..1 | BackboneElement | Witness and notary information. The first witness should be the author of the document Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81339-4
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(ADI Witness | ADI Notary) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:administrative_information | C | 0..1 | BackboneElement | Administrative information associated with this personal advance care plan Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title | S | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81381-6
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Composition.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Composition.status | required | ADICompositionStatusVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS` From this IG
Composition.type | extensible | AdvanceHealthcareDirectiveCategoriesLOINC `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4` From https://vsac.nlm.nih.gov
Composition.category | example | Pattern Value: LOINC Code 42348-3("Advance healthcare directives") `http://hl7.org/fhir/ValueSet/document-classcodes` From the FHIR Standard
Composition.attester.mode | required | Pattern Value: personal `http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1` From the FHIR Standard
Composition.relatesTo.code | required | DocumentRelationshipType `http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1` From the FHIR Standard
Composition.event.code | example | Pattern Value: acp-services("Advance care planning services") `http://terminology.hl7.org/ValueSet/v3-ActCode`
Composition.section.code | example | DocumentSectionCodes `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:healthcare_agent.code | example | Pattern Value: LOINC Code 81335-2 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:healthcare_agent.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:healthcare_agent.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:healthcare_agent.emptyReason | required | ADINoHealthcareAgentIncludedReasonVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS` From this IG
Composition.section:gpp_for_certain_health_condition.code | example | Pattern Value: LOINC Code 81336-0 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_for_certain_health_condition.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:gpp_for_certain_health_condition.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:gpp_for_certain_health_condition.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:gpp_personal_care_experience.code | example | Pattern Value: LOINC Code 81338-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_personal_care_experience.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:gpp_personal_care_experience.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:gpp_personal_care_experience.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:gpp_upon_death.code | example | Pattern Value: LOINC Code 81337-8 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:gpp_upon_death.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:gpp_upon_death.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:gpp_upon_death.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:minimal_source_form.code | example | Pattern Value: minimal_source_form `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:minimal_source_form.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:minimal_source_form.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:minimal_source_form.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:additional_documentation.code | example | Pattern Value: LOINC Code 77599-9 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:additional_documentation.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:additional_documentation.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:additional_documentation.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:witness_and_notary.code | example | Pattern Value: LOINC Code 81339-4 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:witness_and_notary.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:witness_and_notary.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:witness_and_notary.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard
Composition.section:administrative_information.code | example | Pattern Value: LOINC Code 81381-6 `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard
Composition.section:administrative_information.mode | required | ListMode `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` From the FHIR Standard
Composition.section:administrative_information.orderedBy | preferred | ListOrderCodes `http://hl7.org/fhir/ValueSet/list-order` From the FHIR Standard
Composition.section:administrative_information.emptyReason | preferred | ListEmptyReasons `http://hl7.org/fhir/ValueSet/list-empty-reason` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
Composition-section-code-equals-type | error | Composition | Composition section code must equal Composition type when section is portable_medical_orders : section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type |
HCA-section-cardinality | error | Composition | If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent) : (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1 |
HCA-section-emptyReason-required | error | Composition | section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries. : section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists() |
HCA-section-entries | error | Composition.section:healthcare_agent | If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist : entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists()) |
cmp-1 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists() |
cmp-2 | error | Composition.section, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:minimal_source_form, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information | A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty() |
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Composition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Composition | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from ADICompositionHeader

Summary

Mandatory: 5 elements(15 nested mandatory elements)
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- ADI Healthcare Agent Consent (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentConsent)
- ADI Healthcare Agent Participant (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant)
- ADI PtAuthored Care Plan (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PreferenceCarePlan)
- ADI PtAuthored Care Experience Preference (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-CareExperiencePreference)
- ADI Personal Priorities Organizer (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalPrioritiesOrganizer)
- ADI Personal Goal (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalGoal)
- ADI PtAuthored Personal Intervention Preference (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalInterventionPreference)
- ADI Autopsy Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-AutopsyObservation)
- ADI Organ Donation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-OrganDonationObservation)
- ADI Upon Death Preferences (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-UponDeathPreferences)
- ADI Minimal Source Form (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIMinimalSourceFormInformation)
- ADI Documentation Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentationObservation)
- ADI Witness (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Witness)
- ADI Notary (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Notary)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.section

Maturity: 2

Other representations of profile: CSV, Excel, Schematron