HL7 FHIR Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment 2)

BreastSpecimenProfile

{
  "resourceType" : "StructureDefinition",
  "id" : "oncology-BreastSpecimen",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>BC BreastSpecimen Profile</b></p>\n  <p>Specimen resulting from biopsy or excision of breast and surrounding tissue.</p>\n  <p><b>BC Mapping Summary</b></p>\n  <p><pre>oncology.BreastSpecimen maps to Specimen:\n  AccessionIdentifier maps to accessionIdentifier\n  SpecimenStatus maps to status\n  Type maps to type\n  CollectionSource maps to subject\n  CollectionSite.AnatomicalLocation maps to collection.bodySite\n  CollectionMethod.CodeableConcept maps to collection.method\n  SourceSpecimen maps to parent\n  ReceivedTime maps to receivedTime\n  SpecimenContainer.Identifier maps to container.identifier\n  SpecimenContainer.Details maps to container.description\n  SpecimenContainer.Type maps to container.type\n  SpecimenContainer.Capacity maps to container.capacity\n  SpecimenContainer.SpecimenQuantity maps to container.specimenQuantity\n  SpecimenContainer.Additive maps to container.additive[x]\n  ColdIschemiaTime maps to processing (slice on = procedure)\n  ColdIschemiaTime.TimePeriod maps to processing.time[x]\n  ColdIschemiaTime._Concept maps to processing.procedure\n  constrain processing.additive to 0..0\n</pre></p>\n</div>"
  },
  "url" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen",
  "identifier" : [
    {
      "system" : "http://hl7.org/fhir/us/breastcancer",
      "value" : "oncology.BreastSpecimen"
    }
  ],
  "version" : "0.2.0",
  "name" : "BreastSpecimenProfile",
  "title" : "BC BreastSpecimen Profile",
  "status" : "draft",
  "date" : "2018-08-17T00:00:00+00:00",
  "publisher" : "The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cic/index.cfm"
        }
      ]
    }
  ],
  "description" : "Specimen resulting from biopsy or excision of breast and surrounding tissue.",
  "fhirVersion" : "3.0.1",
  "mapping" : [
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/w5",
      "name" : "W5 Mapping"
    },
    {
      "identity" : "v2",
      "uri" : "http://hl7.org/v2",
      "name" : "HL7 v2 Mapping"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Specimen",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Specimen",
  "derivation" : "constraint",
  "snapshot" : {
    "element" : [
      {
        "id" : "Specimen:oncology-BreastSpecimen",
        "path" : "Specimen",
        "short" : "BC BreastSpecimen Profile",
        "definition" : "Specimen resulting from biopsy or excision of breast and surrounding tissue.",
        "min" : 0,
        "max" : "*",
        "constraint" : [
          {
            "key" : "dom-2",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
            "expression" : "contained.contained.empty()",
            "xpath" : "not(parent::f:contained and f:contained)",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-1",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain any narrative",
            "expression" : "contained.text.empty()",
            "xpath" : "not(parent::f:contained and f:text)",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-4",
            "severity" : "error",
            "human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
            "expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
            "xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-3",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
            "expression" : "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
            "xpath" : "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
            "source" : "DomainResource"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Entity. Role, or Act"
          },
          {
            "identity" : "rim",
            "map" : "Role[classCode=SPEC]"
          },
          {
            "identity" : "w5",
            "map" : "clinical.diagnostics"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.id",
        "path" : "Specimen.id",
        "short" : "Logical id of this artifact",
        "definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "id"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.meta",
        "path" : "Specimen.meta",
        "short" : "Metadata about the resource",
        "definition" : "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.meta",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Meta"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.implicitRules",
        "path" : "Specimen.implicitRules",
        "short" : "A set of rules under which this content was created",
        "definition" : "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
        "comment" : "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.implicitRules",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "isModifier" : true,
        "isSummary" : true
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.language",
        "path" : "Specimen.language",
        "short" : "Language of the resource content",
        "definition" : "The base language in which the resource is written.",
        "comment" : "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.language",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
              "valueReference" : {
                "reference" : "http://hl7.org/fhir/ValueSet/all-languages"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "Language"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "extensible",
          "description" : "A human language.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/languages"
          }
        }
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.text",
        "path" : "Specimen.text",
        "short" : "Text summary of the resource, for human interpretation",
        "definition" : "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
        "comment" : "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
        "alias" : [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.text",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Narrative"
          }
        ],
        "condition" : [
          "dom-1"
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Act.text?"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.contained",
        "path" : "Specimen.contained",
        "short" : "Contained, inline Resources",
        "definition" : "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
        "comment" : "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
        "alias" : [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.contained",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Resource"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension",
        "path" : "Specimen.extension",
        "slicing" : {
          "id" : "3",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:collectiontime",
        "path" : "Specimen.extension",
        "sliceName" : "collectiontime",
        "definition" : "When the sample was obtained, as a specific time or time period.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-CollectionTime-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:specimentreatment",
        "path" : "Specimen.extension",
        "sliceName" : "specimentreatment",
        "definition" : "Treatment performed on the specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecimenTreatment-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:handlingrisk",
        "path" : "Specimen.extension",
        "sliceName" : "handlingrisk",
        "definition" : "Cautions on the handling of this specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-HandlingRisk-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:specialhandling",
        "path" : "Specimen.extension",
        "sliceName" : "specialhandling",
        "definition" : "Information about the proper handling of the specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecialHandling-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:tumoridentifier",
        "path" : "Specimen.extension",
        "sliceName" : "tumoridentifier",
        "definition" : "A human-readable identifier for the lesion; e.g., a letter or integer.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TumorIdentifier-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.modifierExtension",
        "path" : "Specimen.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.identifier",
        "path" : "Specimen.identifier",
        "short" : "External Identifier",
        "definition" : "Id for specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-2"
          },
          {
            "identity" : "rim",
            "map" : ".id"
          },
          {
            "identity" : "w5",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.accessionIdentifier",
        "path" : "Specimen.accessionIdentifier",
        "short" : "Identifier assigned by the lab",
        "definition" : "The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Identifier",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-AccessionIdentifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-30 (v2.7+)"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id"
          },
          {
            "identity" : "w5",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.status",
        "path" : "Specimen.status",
        "short" : "available | unavailable | unsatisfactory | entered-in-error",
        "definition" : "The availability of the specimen.",
        "comment" : "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "code"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenStatus"
            }
          ],
          "strength" : "required",
          "description" : "Codes providing the status/availability of a specimen.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-status"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-20"
          },
          {
            "identity" : "rim",
            "map" : "status"
          },
          {
            "identity" : "w5",
            "map" : "status"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.type",
        "path" : "Specimen.type",
        "short" : "Kind of material that forms the specimen",
        "definition" : "The kind of material that forms the specimen.",
        "comment" : "The type can change the way that a specimen is handled, and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "isSummary" : true,
        "binding" : {
          "strength" : "required",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenTypeVS"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-4 and possibly SPM-5"
          },
          {
            "identity" : "rim",
            "map" : ".code"
          },
          {
            "identity" : "w5",
            "map" : "what"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.subject",
        "path" : "Specimen.subject",
        "short" : "Where the specimen came from. This may be from the patient(s) or from the environment or a device",
        "definition" : "Where the specimen came from. This may be from the patient(s) or from the environment or a device.",
        "requirements" : "Must know the subject context.",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Group"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-device"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".scoper  or  .scoper.playsRole"
          },
          {
            "identity" : "w5",
            "map" : "who.focus"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.receivedTime",
        "path" : "Specimen.receivedTime",
        "short" : "The time when specimen was received for processing",
        "definition" : "Time when specimen was received for processing or testing.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "dateTime"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-18"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime"
          },
          {
            "identity" : "w5",
            "map" : "when.done"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.parent",
        "path" : "Specimen.parent",
        "short" : "Specimen from which this specimen originated",
        "definition" : "Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen.",
        "comment" : "The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.request",
        "path" : "Specimen.request",
        "short" : "Why the specimen was collected",
        "definition" : "Details concerning a test or procedure request that required a specimen to be collected.",
        "comment" : "The request may be explicit or implied such with a ProcedureRequest that requires a blood draw.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "ORC? OBR-2/3?"
          },
          {
            "identity" : "rim",
            "map" : "outboundRelationship[typeCode=FLFS].target"
          },
          {
            "identity" : "w5",
            "map" : "why"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection",
        "path" : "Specimen.collection",
        "short" : "Collection details",
        "definition" : "Details concerning the specimen collection.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-14"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.id",
        "path" : "Specimen.collection.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.extension",
        "path" : "Specimen.collection.extension",
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.modifierExtension",
        "path" : "Specimen.collection.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.collector",
        "path" : "Specimen.collection.collector",
        "short" : "Who collected the specimen",
        "definition" : "Person who collected the specimen.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/StructureDefinition/Practitioner"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "PRT"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=PFM].role"
          },
          {
            "identity" : "w5",
            "map" : "who.actor"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.collected[x]",
        "path" : "Specimen.collection.collected[x]",
        "short" : "Collection time",
        "definition" : "Time when specimen was collected from subject - the physiologically relevant time.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "dateTime"
          },
          {
            "code" : "Period"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-17"
          },
          {
            "identity" : "rim",
            "map" : ".effectiveTime"
          },
          {
            "identity" : "w5",
            "map" : "when.init"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.quantity",
        "path" : "Specimen.collection.quantity",
        "short" : "The quantity of specimen collected",
        "definition" : "The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Quantity",
            "profile" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-12"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].role[classCode=SPEC].player.quantity"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.method",
        "path" : "Specimen.collection.method",
        "short" : "Technique used to perform collection",
        "definition" : "A coded value specifying the technique that is used to perform the procedure.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "strength" : "required",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenCollectionMethodVS"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-7"
          },
          {
            "identity" : "rim",
            "map" : ".methodCode"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.bodySite",
        "path" : "Specimen.collection.bodySite",
        "short" : "Anatomical collection site",
        "definition" : "Anatomical location from which the specimen was collected (if subject is a patient). This is the target site.  This element is not used for environmental specimens.",
        "comment" : "If the use case requires  BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately)  then use the standard extension [body-site-instance](extension-body-site-instance.html).",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "strength" : "required",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSiteVS"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-8 and SPM-9"
          },
          {
            "identity" : "rim",
            "map" : ".targetSiteCode"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing",
        "path" : "Specimen.processing",
        "slicing" : {
          "id" : "1",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "procedure"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "short" : "Processing and processing step details",
        "definition" : "Details concerning processing and processing steps for the specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime",
        "path" : "Specimen.processing",
        "sliceName" : "oncology-ColdIschemiaTime",
        "short" : "ColdIschemiaTime",
        "definition" : "The time period between the chilling of a tissue or tissue sample and the time it is warmed.\nCIMI Alignment: In CIMI Version 0.0.4, specimen processing is represented as a 'SpecimenProcessingPerformed' clinical statement, mapped to FHIR Procedure. However, specimen processing maps to FHIR Specimen.processing, part of the Specimen resource. It would be a difficult mapping exercise (and beyond the scope of this IG) to express the mapping rule that any CIMI SpecimenProcessingPerformed clinical statement needs to mapped to FHIR by (1) finding the corresponding Specimen entity, and (2) mapping the content of (possibly multiple) SpecimenProcessingPerformed into the FHIR Specimen resource. To avoid this complexity, the breast cancer model expresses the cold ischemia time as an attribute of the BreastSpecimen rather than a separate procedure.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.id",
        "path" : "Specimen.processing.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.extension",
        "path" : "Specimen.processing.extension",
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.modifierExtension",
        "path" : "Specimen.processing.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.description",
        "path" : "Specimen.processing.description",
        "short" : "Textual description of procedure",
        "definition" : "Textual description of procedure.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".text"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure",
        "path" : "Specimen.processing.procedure",
        "short" : "Indicates the treatment step  applied to the specimen",
        "definition" : "A coded value specifying the procedure used to process the specimen.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenProcessingProcedure"
            }
          ],
          "strength" : "example",
          "description" : "Type indicating the technique used to process the specimen",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-processing-procedure"
          }
        },
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".code"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.id",
        "path" : "Specimen.processing.procedure.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.extension",
        "path" : "Specimen.processing.procedure.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "description" : "Extensions are always sliced by (at least) url",
          "rules" : "open"
        },
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding",
        "path" : "Specimen.processing.procedure.coding",
        "slicing" : {
          "id" : "2",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "code"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "short" : "Code defined by a terminology system",
        "definition" : "A reference to a code defined by a terminology system.",
        "comment" : "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
        "requirements" : "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
        "min" : 1,
        "max" : "*",
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.1-8, C*E.10-22"
          },
          {
            "identity" : "rim",
            "map" : "union(., ./translation)"
          },
          {
            "identity" : "orim",
            "map" : "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9",
        "path" : "Specimen.processing.procedure.coding",
        "sliceName" : "Fixed_44778-9",
        "short" : "Cold ischemic time {Organ}",
        "definition" : "Cold ischemic time {Organ}",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.id",
        "path" : "Specimen.processing.procedure.coding.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.extension",
        "path" : "Specimen.processing.procedure.coding.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "description" : "Extensions are always sliced by (at least) url",
          "rules" : "open"
        },
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.system",
        "path" : "Specimen.processing.procedure.coding.system",
        "short" : "Identity of the terminology system",
        "definition" : "The identification of the code system that defines the meaning of the symbol in the code.",
        "comment" : "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
        "requirements" : "Need to be unambiguous about the source of the definition of the symbol.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "fixedUri" : "http://loinc.org",
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.3"
          },
          {
            "identity" : "rim",
            "map" : "./codeSystem"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.version",
        "path" : "Specimen.processing.procedure.coding.version",
        "short" : "Version of the system - if relevant",
        "definition" : "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
        "comment" : "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.7"
          },
          {
            "identity" : "rim",
            "map" : "./codeSystemVersion"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.code",
        "path" : "Specimen.processing.procedure.coding.code",
        "short" : "Symbol in syntax defined by the system",
        "definition" : "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
        "requirements" : "Need to refer to a particular code in the system.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "code"
          }
        ],
        "fixedCode" : "44778-9",
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.1"
          },
          {
            "identity" : "rim",
            "map" : "./code"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.display",
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean" : true
          }
        ],
        "path" : "Specimen.processing.procedure.coding.display",
        "short" : "Representation defined by the system",
        "definition" : "A representation of the meaning of the code in the system, following the rules of the system.",
        "requirements" : "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.2 - but note this is not well followed"
          },
          {
            "identity" : "rim",
            "map" : "CV.displayName"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.userSelected",
        "path" : "Specimen.processing.procedure.coding.userSelected",
        "short" : "If this coding was chosen directly by the user",
        "definition" : "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
        "comment" : "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
        "requirements" : "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "boolean"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "Sometimes implied by being first"
          },
          {
            "identity" : "rim",
            "map" : "CD.codingRationale"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.text",
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean" : true
          }
        ],
        "path" : "Specimen.processing.procedure.text",
        "short" : "Plain text representation of the concept",
        "definition" : "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
        "comment" : "Very often the text is the same as a displayName of one of the codings.",
        "requirements" : "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.9. But note many systems use C*E.2 for this"
          },
          {
            "identity" : "rim",
            "map" : "./originalText[mediaType/code=\"text/plain\"]/data"
          },
          {
            "identity" : "orim",
            "map" : "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.additive",
        "path" : "Specimen.processing.additive",
        "short" : "Material used in the processing step",
        "definition" : "Material used in the processing step.",
        "min" : 0,
        "max" : "0",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/StructureDefinition/Substance"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-6"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=CSM].role[classCode=ADTV].code"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.timePeriod",
        "path" : "Specimen.processing.timePeriod",
        "short" : "Date and time of specimen processing",
        "definition" : "A record of the time or period when the specimen processing occurred.  For example the time of sample fixation or the period of time the sample was in formalin.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Period"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".effectiveTime"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container",
        "path" : "Specimen.container",
        "short" : "Direct container of specimen (tube/slide, etc.)",
        "definition" : "The container holding the specimen.  The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".player.scopingRole[classCode=CONT].scoper"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.id",
        "path" : "Specimen.container.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.extension",
        "path" : "Specimen.container.extension",
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.modifierExtension",
        "path" : "Specimen.container.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.identifier",
        "path" : "Specimen.container.identifier",
        "short" : "Id for the container",
        "definition" : "Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Identifier",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-element-Identifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SAC-3"
          },
          {
            "identity" : "rim",
            "map" : ".id"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.description",
        "path" : "Specimen.container.description",
        "short" : "Textual description of the container",
        "definition" : "Textual description of the container.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".desc"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.type",
        "path" : "Specimen.container.type",
        "short" : "Kind of container directly associated with specimen",
        "definition" : "The type of container associated with the specimen (e.g. slide, aliquot, etc.).",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenContainerType"
            }
          ],
          "strength" : "example",
          "description" : "Type of specimen container",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-container-type"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-27"
          },
          {
            "identity" : "rim",
            "map" : ".code"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.capacity",
        "path" : "Specimen.container.capacity",
        "short" : "Container volume or size",
        "definition" : "The capacity (volume or other measure) the container may contain.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Quantity",
            "profile" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20"
          },
          {
            "identity" : "rim",
            "map" : ".quantity"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.specimenQuantity",
        "path" : "Specimen.container.specimenQuantity",
        "short" : "Quantity of specimen within container",
        "definition" : "The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Quantity",
            "profile" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SAC-23 (value) SAC-24 (units"
          },
          {
            "identity" : "rim",
            "map" : ".playedRole[classCode=CONT].quantity"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.container.additive[x]",
        "path" : "Specimen.container.additive[x]",
        "short" : "Additive associated with container",
        "definition" : "Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenContainerAdditive"
            }
          ],
          "strength" : "example",
          "description" : "Substance added to specimen container",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/v2-0371"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SAC-27"
          },
          {
            "identity" : "rim",
            "map" : ".scopesRole[classCode=ADTV].player"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.note",
        "path" : "Specimen.note",
        "short" : "Comments",
        "definition" : "To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Annotation"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "Specimen:oncology-BreastSpecimen",
        "path" : "Specimen",
        "short" : "BC BreastSpecimen Profile",
        "definition" : "Specimen resulting from biopsy or excision of breast and surrounding tissue."
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:collectiontime",
        "path" : "Specimen.extension",
        "sliceName" : "collectiontime",
        "definition" : "When the sample was obtained, as a specific time or time period.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-CollectionTime-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:specimentreatment",
        "path" : "Specimen.extension",
        "sliceName" : "specimentreatment",
        "definition" : "Treatment performed on the specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecimenTreatment-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:handlingrisk",
        "path" : "Specimen.extension",
        "sliceName" : "handlingrisk",
        "definition" : "Cautions on the handling of this specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-HandlingRisk-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:specialhandling",
        "path" : "Specimen.extension",
        "sliceName" : "specialhandling",
        "definition" : "Information about the proper handling of the specimen.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecialHandling-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.extension:tumoridentifier",
        "path" : "Specimen.extension",
        "sliceName" : "tumoridentifier",
        "definition" : "A human-readable identifier for the lesion; e.g., a letter or integer.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TumorIdentifier-extension"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.accessionIdentifier",
        "path" : "Specimen.accessionIdentifier",
        "type" : [
          {
            "code" : "Identifier",
            "profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-AccessionIdentifier"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.type",
        "path" : "Specimen.type",
        "min" : 1,
        "max" : "1",
        "binding" : {
          "strength" : "required",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenTypeVS"
          }
        }
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.subject",
        "path" : "Specimen.subject",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Group"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-device"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.parent",
        "path" : "Specimen.parent",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen"
          }
        ]
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection",
        "path" : "Specimen.collection"
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.method",
        "path" : "Specimen.collection.method",
        "binding" : {
          "strength" : "required",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenCollectionMethodVS"
          }
        }
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.collection.bodySite",
        "path" : "Specimen.collection.bodySite",
        "binding" : {
          "strength" : "required",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSiteVS"
          }
        }
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing",
        "path" : "Specimen.processing",
        "slicing" : {
          "id" : "1",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "procedure"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime",
        "path" : "Specimen.processing",
        "sliceName" : "oncology-ColdIschemiaTime",
        "short" : "ColdIschemiaTime",
        "definition" : "The time period between the chilling of a tissue or tissue sample and the time it is warmed.\nCIMI Alignment: In CIMI Version 0.0.4, specimen processing is represented as a 'SpecimenProcessingPerformed' clinical statement, mapped to FHIR Procedure. However, specimen processing maps to FHIR Specimen.processing, part of the Specimen resource. It would be a difficult mapping exercise (and beyond the scope of this IG) to express the mapping rule that any CIMI SpecimenProcessingPerformed clinical statement needs to mapped to FHIR by (1) finding the corresponding Specimen entity, and (2) mapping the content of (possibly multiple) SpecimenProcessingPerformed into the FHIR Specimen resource. To avoid this complexity, the breast cancer model expresses the cold ischemia time as an attribute of the BreastSpecimen rather than a separate procedure.",
        "min" : 0,
        "max" : "1"
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure",
        "path" : "Specimen.processing.procedure"
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding",
        "path" : "Specimen.processing.procedure.coding",
        "slicing" : {
          "id" : "2",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "code"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "min" : 1,
        "max" : "*"
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9",
        "path" : "Specimen.processing.procedure.coding",
        "sliceName" : "Fixed_44778-9",
        "short" : "Cold ischemic time {Organ}",
        "definition" : "Cold ischemic time {Organ}",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.system",
        "path" : "Specimen.processing.procedure.coding.system",
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