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

BreastSpecimenProfile


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="oncology-BreastSpecimen"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>BC BreastSpecimen Profile</b></p>
  <p>Specimen resulting from biopsy or excision of breast and surrounding tissue.</p>
  <p><b>BC Mapping Summary</b></p>
  <p><pre>oncology.BreastSpecimen maps to Specimen:
  AccessionIdentifier maps to accessionIdentifier
  SpecimenStatus maps to status
  Type maps to type
  CollectionSource maps to subject
  CollectionSite.AnatomicalLocation maps to collection.bodySite
  CollectionMethod.CodeableConcept maps to collection.method
  SourceSpecimen maps to parent
  ReceivedTime maps to receivedTime
  SpecimenContainer.Identifier maps to container.identifier
  SpecimenContainer.Details maps to container.description
  SpecimenContainer.Type maps to container.type
  SpecimenContainer.Capacity maps to container.capacity
  SpecimenContainer.SpecimenQuantity maps to container.specimenQuantity
  SpecimenContainer.Additive maps to container.additive[x]
  ColdIschemiaTime maps to processing (slice on = procedure)
  ColdIschemiaTime.TimePeriod maps to processing.time[x]
  ColdIschemiaTime._Concept maps to processing.procedure
  constrain processing.additive to 0..0
</pre></p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen"/>
  <identifier>
    <system value="http://hl7.org/fhir/us/breastcancer"/>
    <value value="oncology.BreastSpecimen"/>
  </identifier>
  <version value="0.2.0"/>
  <name value="BreastSpecimenProfile"/>
  <title value="BC BreastSpecimen Profile"/>
  <status value="draft"/>
  <date value="2018-08-17T00:00:00+00:00"/>
  <publisher
             value="The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic/index.cfm"/>
    </telecom>
  </contact>
  <description
               value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Specimen"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Specimen"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Specimen:oncology-BreastSpecimen">
      <path value="Specimen"/>
      <short value="BC BreastSpecimen Profile"/>
      <definition
                  value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/>
      <min value="0"/>
      <max value="*"/>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role[classCode=SPEC]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.diagnostics"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.id">
      <path value="Specimen.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.meta">
      <path value="Specimen.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.implicitRules">
      <path value="Specimen.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.language">
      <path value="Specimen.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.text">
      <path value="Specimen.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.contained">
      <path value="Specimen.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension">
      <path value="Specimen.extension"/>
      <slicing id="3">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:collectiontime">
      <path value="Specimen.extension"/>
      <sliceName value="collectiontime"/>
      <definition
                  value="When the sample was obtained, as a specific time or time period."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-CollectionTime-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:specimentreatment">
      <path value="Specimen.extension"/>
      <sliceName value="specimentreatment"/>
      <definition value="Treatment performed on the specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecimenTreatment-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:handlingrisk">
      <path value="Specimen.extension"/>
      <sliceName value="handlingrisk"/>
      <definition value="Cautions on the handling of this specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-HandlingRisk-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:specialhandling">
      <path value="Specimen.extension"/>
      <sliceName value="specialhandling"/>
      <definition value="Information about the proper handling of the specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecialHandling-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:tumoridentifier">
      <path value="Specimen.extension"/>
      <sliceName value="tumoridentifier"/>
      <definition
                  value="A human-readable identifier for the lesion; e.g., a letter or integer."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TumorIdentifier-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.modifierExtension">
      <path value="Specimen.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.identifier">
      <path value="Specimen.identifier"/>
      <short value="External Identifier"/>
      <definition value="Id for specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.accessionIdentifier">
      <path value="Specimen.accessionIdentifier"/>
      <short value="Identifier assigned by the lab"/>
      <definition
                  value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-AccessionIdentifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-30 (v2.7+)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.status">
      <path value="Specimen.status"/>
      <short value="available | unavailable | unsatisfactory | entered-in-error"/>
      <definition value="The availability of the specimen."/>
      <comment
               value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SpecimenStatus"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Codes providing the status/availability of a specimen."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/specimen-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.type">
      <path value="Specimen.type"/>
      <short value="Kind of material that forms the specimen"/>
      <definition value="The kind of material that forms the specimen."/>
      <comment
               value="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 value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenTypeVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-4 and possibly SPM-5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.subject">
      <path value="Specimen.subject"/>
      <short
             value="Where the specimen came from. This may be from the patient(s) or from the environment or a device"/>
      <definition
                  value="Where the specimen came from. This may be from the patient(s) or from the environment or a device."/>
      <requirements value="Must know the subject context."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".scoper  or  .scoper.playsRole"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.receivedTime">
      <path value="Specimen.receivedTime"/>
      <short value="The time when specimen was received for processing"/>
      <definition
                  value="Time when specimen was received for processing or testing."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-18"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.parent">
      <path value="Specimen.parent"/>
      <short value="Specimen from which this specimen originated"/>
      <definition
                  value="Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen."/>
      <comment
               value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.request">
      <path value="Specimen.request"/>
      <short value="Why the specimen was collected"/>
      <definition
                  value="Details concerning a test or procedure request that required a specimen to be collected."/>
      <comment
               value="The request may be explicit or implied such with a ProcedureRequest that requires a blood draw."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="ORC? OBR-2/3?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=FLFS].target"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection">
      <path value="Specimen.collection"/>
      <short value="Collection details"/>
      <definition value="Details concerning the specimen collection."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.id">
      <path value="Specimen.collection.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.extension">
      <path value="Specimen.collection.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.modifierExtension">
      <path value="Specimen.collection.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.collector">
      <path value="Specimen.collection.collector"/>
      <short value="Who collected the specimen"/>
      <definition value="Person who collected the specimen."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PRT"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.collected[x]">
      <path value="Specimen.collection.collected[x]"/>
      <short value="Collection time"/>
      <definition
                  value="Time when specimen was collected from subject - the physiologically relevant time."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-17"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.init"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.quantity">
      <path value="Specimen.collection.quantity"/>
      <short value="The quantity of specimen collected"/>
      <definition
                  value="The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-12"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=SBJ].role[classCode=SPEC].player.quantity"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.method">
      <path value="Specimen.collection.method"/>
      <short value="Technique used to perform collection"/>
      <definition
                  value="A coded value specifying the technique that is used to perform the procedure."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenCollectionMethodVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".methodCode"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.bodySite">
      <path value="Specimen.collection.bodySite"/>
      <short value="Anatomical collection site"/>
      <definition
                  value="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
               value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSiteVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-8 and SPM-9"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.processing">
      <path value="Specimen.processing"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="procedure"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Processing and processing step details"/>
      <definition
                  value="Details concerning processing and processing steps for the specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime">
      <path value="Specimen.processing"/>
      <sliceName value="oncology-ColdIschemiaTime"/>
      <short value="ColdIschemiaTime"/>
      <definition
                  value="The time period between the chilling of a tissue or tissue sample and the time it is warmed.
CIMI Alignment: In CIMI Version 0.0.4, specimen processing is represented as a &#39;SpecimenProcessingPerformed&#39; 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 value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.id">
      <path value="Specimen.processing.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.extension">
      <path value="Specimen.processing.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.modifierExtension">
      <path value="Specimen.processing.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.description">
      <path value="Specimen.processing.description"/>
      <short value="Textual description of procedure"/>
      <definition value="Textual description of procedure."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure">
      <path value="Specimen.processing.procedure"/>
      <short value="Indicates the treatment step  applied to the specimen"/>
      <definition
                  value="A coded value specifying the procedure used to process the specimen."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SpecimenProcessingProcedure"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Type indicating the technique used to process the specimen"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/specimen-processing-procedure"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.id">
      <path value="Specimen.processing.procedure.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.extension">
      <path value="Specimen.processing.procedure.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding">
      <path value="Specimen.processing.procedure.coding"/>
      <slicing id="2">
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Code defined by a terminology system"/>
      <definition value="A reference to a code defined by a terminology system."/>
      <comment
               value="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
                    value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings."/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9">
      <path value="Specimen.processing.procedure.coding"/>
      <sliceName value="Fixed_44778-9"/>
      <short value="Cold ischemic time {Organ}"/>
      <definition value="Cold ischemic time {Organ}"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.id">
      <path value="Specimen.processing.procedure.coding.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.extension">
      <path value="Specimen.processing.procedure.coding.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.system">
      <path value="Specimen.processing.procedure.coding.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="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&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="http://loinc.org"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.version">
      <path value="Specimen.processing.procedure.coding.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="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
               value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.code">
      <path value="Specimen.processing.procedure.coding.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="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 value="Need to refer to a particular code in the system."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="44778-9"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="Specimen.processing.procedure.coding.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.userSelected">
      <path value="Specimen.processing.procedure.coding.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/>
      <comment
               value="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 &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
      <requirements
                    value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="Specimen.processing.procedure.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="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
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.additive">
      <path value="Specimen.processing.additive"/>
      <short value="Material used in the processing step"/>
      <definition value="Material used in the processing step."/>
      <min value="0"/>
      <max value="0"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=CSM].role[classCode=ADTV].code"/>
      </mapping>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.timePeriod">
      <path value="Specimen.processing.timePeriod"/>
      <short value="Date and time of specimen processing"/>
      <definition
                  value="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 value="0"/>
      <max value="1"/>
      <type>
        <code value="Period"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container">
      <path value="Specimen.container"/>
      <short value="Direct container of specimen (tube/slide, etc.)"/>
      <definition
                  value="The container holding the specimen.  The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value=".player.scopingRole[classCode=CONT].scoper"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.id">
      <path value="Specimen.container.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.extension">
      <path value="Specimen.container.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.modifierExtension">
      <path value="Specimen.container.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the 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
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.identifier">
      <path value="Specimen.container.identifier"/>
      <short value="Id for the container"/>
      <definition
                  value="Id for container. There may be multiple; a manufacturer&#39;s bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-element-Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="SAC-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.description">
      <path value="Specimen.container.description"/>
      <short value="Textual description of the container"/>
      <definition value="Textual description of the container."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".desc"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.type">
      <path value="Specimen.container.type"/>
      <short value="Kind of container directly associated with specimen"/>
      <definition
                  value="The type of container associated with the specimen (e.g. slide, aliquot, etc.)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SpecimenContainerType"/>
        </extension>
        <strength value="example"/>
        <description value="Type of specimen container"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/specimen-container-type"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SPM-27"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.capacity">
      <path value="Specimen.container.capacity"/>
      <short value="Container volume or size"/>
      <definition
                  value="The capacity (volume or other measure) the container may contain."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".quantity"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.specimenQuantity">
      <path value="Specimen.container.specimenQuantity"/>
      <short value="Quantity of specimen within container"/>
      <definition
                  value="The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="SAC-23 (value) SAC-24 (units"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".playedRole[classCode=CONT].quantity"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.additive[x]">
      <path value="Specimen.container.additive[x]"/>
      <short value="Additive associated with container"/>
      <definition
                  value="Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SpecimenContainerAdditive"/>
        </extension>
        <strength value="example"/>
        <description value="Substance added to specimen container"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v2-0371"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SAC-27"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".scopesRole[classCode=ADTV].player"/>
      </mapping>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.note">
      <path value="Specimen.note"/>
      <short value="Comments"/>
      <definition
                  value="To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen)."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Specimen:oncology-BreastSpecimen">
      <path value="Specimen"/>
      <short value="BC BreastSpecimen Profile"/>
      <definition
                  value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:collectiontime">
      <path value="Specimen.extension"/>
      <sliceName value="collectiontime"/>
      <definition
                  value="When the sample was obtained, as a specific time or time period."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-CollectionTime-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:specimentreatment">
      <path value="Specimen.extension"/>
      <sliceName value="specimentreatment"/>
      <definition value="Treatment performed on the specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecimenTreatment-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:handlingrisk">
      <path value="Specimen.extension"/>
      <sliceName value="handlingrisk"/>
      <definition value="Cautions on the handling of this specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-HandlingRisk-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:specialhandling">
      <path value="Specimen.extension"/>
      <sliceName value="specialhandling"/>
      <definition value="Information about the proper handling of the specimen."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-SpecialHandling-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.extension:tumoridentifier">
      <path value="Specimen.extension"/>
      <sliceName value="tumoridentifier"/>
      <definition
                  value="A human-readable identifier for the lesion; e.g., a letter or integer."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TumorIdentifier-extension"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.accessionIdentifier">
      <path value="Specimen.accessionIdentifier"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-AccessionIdentifier"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.type">
      <path value="Specimen.type"/>
      <min value="1"/>
      <max value="1"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenTypeVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.subject">
      <path value="Specimen.subject"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.parent">
      <path value="Specimen.parent"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection">
      <path value="Specimen.collection"/>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.method">
      <path value="Specimen.collection.method"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSpecimenCollectionMethodVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.collection.bodySite">
      <path value="Specimen.collection.bodySite"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSiteVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.processing">
      <path value="Specimen.processing"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="procedure"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime">
      <path value="Specimen.processing"/>
      <sliceName value="oncology-ColdIschemiaTime"/>
      <short value="ColdIschemiaTime"/>
      <definition
                  value="The time period between the chilling of a tissue or tissue sample and the time it is warmed.
CIMI Alignment: In CIMI Version 0.0.4, specimen processing is represented as a &#39;SpecimenProcessingPerformed&#39; 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 value="0"/>
      <max value="1"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure">
      <path value="Specimen.processing.procedure"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding">
      <path value="Specimen.processing.procedure.coding"/>
      <slicing id="2">
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <min value="1"/>
      <max value="*"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9">
      <path value="Specimen.processing.procedure.coding"/>
      <sliceName value="Fixed_44778-9"/>
      <short value="Cold ischemic time {Organ}"/>
      <definition value="Cold ischemic time {Organ}"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.system">
      <path value="Specimen.processing.procedure.coding.system"/>
      <fixedUri value="http://loinc.org"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.procedure.coding:Fixed_44778-9.code">
      <path value="Specimen.processing.procedure.coding.code"/>
      <fixedCode value="44778-9"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.additive">
      <path value="Specimen.processing.additive"/>
      <min value="0"/>
      <max value="0"/>
    </element>
    <element
             id="Specimen:oncology-BreastSpecimen.processing:oncology-ColdIschemiaTime.timePeriod">
      <path value="Specimen.processing.timePeriod"/>
      <type>
        <code value="Period"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container">
      <path value="Specimen.container"/>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.identifier">
      <path value="Specimen.container.identifier"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-element-Identifier"/>
      </type>
    </element>
    <element id="Specimen:oncology-BreastSpecimen.container.additive[x]">
      <path value="Specimen.container.additive[x]"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Substance"/>
      </type>
    </element>
  </differential>
</StructureDefinition>