IHE PCC - Routine Interfacility Patient Transport (RIPT)
2.0.0-draft - ci-build

IHE PCC - Routine Interfacility Patient Transport (RIPT), published by IHE Patient Care Coordination. This is not an authorized publication; it is the continuous build for version 2.0.0-draft). This version is based on the current content of https://github.com/IHE/PCC.RIPT/ and changes regularly. See the Directory of published versions

## Resource Profile: IHE_RIPT_Composition - Detailed Descriptions

Active as of 2023-01-27

Definitions for the IHE.PCC.RIPT.Composition resource profile.

- Differential Elements Table
- Key Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be found here.

1. Composition
2. Composition.subject
Control | 10..1
3. Composition.section
Control | 31..*
4. Composition.section:sectionCertificationOfMedicalNecessity
SliceName | sectionCertificationOfMedicalNecessity
Definition | The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature.
Control | 0..1
5. Composition.section:sectionCertificationOfMedicalNecessity.code
Control | 1..?
Must Support | true
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="52016-3"/> </coding> </valueCodeableConcept>
6. Composition.section:sectionCertificationOfMedicalNecessity.entry
Definition | Indication of whether a physician certification statement (PCS) is available documenting the medical necessity for the EMS encounter. The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature.
Control | 0..?
Must Support | true
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
7. Composition.section:sectionCertificationOfMedicalNecessity.entry:MedicalNecessityEntry
SliceName | MedicalNecessityEntry
Control | 0..1
Type | Reference(Observation)
Must Support | true
8. Composition.section:sectionCertificationOfMedicalNecessity.entry:Signature
SliceName | Signature
Control | 0..1
Type | Reference(Observation)
Must Support | true
9. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignatureDate
SliceName | SignatureDate
Control | 0..1
Type | Reference(Observation)
Must Support | true
10. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignerProviderType
SliceName | SignerProviderType
Control | 0..1
Type | Reference(PractitionerRole)
Must Support | true
11. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignerName
SliceName | SignerName
Control | 0..1
Type | Reference(Practitioner)
Must Support | true
12. Composition.section:sectionCertificationOfMedicalNecessity.entry:Justification
SliceName | Justification
Control | 0..1
Type | Reference(Observation)
Must Support | true
13. Composition.section:sectionCertificationOfMedicalNecessity.entry:ReasonForTransport
SliceName | ReasonForTransport
Control | 0..1
Type | Reference(Observation)
Must Support | true
14. Composition.section:sectionCertificationOfMedicalNecessity.entry:PriorAuthorizationCode
SliceName | PriorAuthorizationCode
Control | 0..1
Type | Reference(Observation)
15. Composition.section:sectionCertificationOfMedicalNecessity.entry:PriorAuthorizationCodePayer
SliceName | PriorAuthorizationCodePayer
Control | 0..1
Type | Reference(Observation)
16. Composition.section:sectionCoverage
SliceName | sectionCoverage
Definition | The insurance information for the patient to cover the encounter event.
Control | 0..1
17. Composition.section:sectionCoverage.code
Control | 1..?
Must Support | true
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="48768-6"/> </coding> </valueCodeableConcept>
18. Composition.section:sectionCoverage.entry
Definition | Contains data on the patient's payers, whether a 'third party' insurance, self-pay, other payer or guarantor, or some combination of payers, and is used to define which entity is the responsible fiduciary for the financial aspects of a patient's care
Control | 0..1
Type | Reference(Coverage)
Must Support | true
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
19. Composition.section:sectionCoverage.entry:Coverage
SliceName | Coverage
Control | 0..1
Must Support | true
20. Composition.section:sectionReasonForReferral
SliceName | sectionReasonForReferral
Definition | This section shall include at least one entry describing the reason for referral as described in the Entry Content Module.
Control | 0..1
21. Composition.section:sectionReasonForReferral.code
Control | 1..?
Must Support | true
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="42349-1"/> </coding> </valueCodeableConcept>
22. Composition.section:sectionReasonForReferral.entry
Definition | Indication of whether a physician certification statement (PCS) is available documenting the medical necessity for the EMS encounter. The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature.
Control | 2..2
Must Support | true
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
23. Composition.section:sectionReasonForReferral.entry:SimpleObservations
SliceName | SimpleObservations
Control | 1..1
Type | Reference(Observation)
Must Support | true
24. Composition.section:sectionReasonForReferral.entry:ConditionsEntry
SliceName | ConditionsEntry
Control | 1..1
Type | Reference(ConditionUvIps)
Must Support | true
25. Composition.section:sectionTransportInstructions
SliceName | sectionTransportInstructions
Definition | This section contains narrative information provided by the patient’s care provider(s) to indicate any care that should be rendered during the transport.
Control | 0..1
26. Composition.section:sectionTransportInstructions.code
Control | 1..?
Must Support | true
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="74213-0"/> </coding> </valueCodeableConcept>
27. Composition.section:sectionTransportInstructions.entry
Definition | This section contains information provided by the patient’s care provider(s) to indicate any care that should be rendered during the transport and the Destination information.
Control | 0..?
Must Support | true
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
28. Composition.section:sectionTransportInstructions.entry:TrasnportInstructions
SliceName | TrasnportInstructions
Control | 0..1
Must Support | true
29. Composition.section:sectionTransportInstructions.entry:DestinationInformation
SliceName | DestinationInformation
Control | 0..1
Type | Reference(Location)
Must Support | true

Guidance on how to interpret the contents of this table can be found here.

1. Composition
Definition | International Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).
Control | 0..*
Must Support | true
Summary | false
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Composition.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Summary | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. Composition.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Must Support | true
Summary | false
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Composition.extension:versionNumber
SliceName | versionNumber
Definition | Version specific identifier for the composition, assigned when each version is created/updated.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(versionNumber) (Extension Type: string)
Comments | While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. Composition.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
6. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Must Support | true
Summary | true
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Control | 1..1
Binding | The codes SHALL be taken from CompositionStatus The workflow/clinical status of the composition.
Type | code
Is Modifier | true
Must Support | true
Summary | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Comments | If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
8. Composition.type
Definition | Specifies that this composition refers to a Patient Summary (Loinc "60591-5") Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from FHIRDocumentTypeCodes Type of a composition.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="60591-5"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Composition.subject
Definition | Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the IPS the subject is always the patient. Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).
Control | 10..1
Type | Reference(PatientUvIps|Resource)
Must Support | true
Summary | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Comments | For clinical documents, this is usually the patient.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. Composition.subject.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Control | 10..1 This element is affected by the following invariants: ref-1
Type | string
Must Support | true
Summary | true
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Composition.encounter
Definition | Describes the clinical encounter or type of care this documentation is associated with.
Control | 0..1
Type | Reference(Encounter)
Must Support | true
Summary | true
Requirements | Provides context for the composition and supports searching.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Control | 1..1
Type | dateTime
Must Support | true
Summary | true
Requirements | dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging. dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Composition.author
Definition | Identifies who is responsible for the information in the IPS, not necessarily who typed it in. The type of author(s) contribute to determine the "nature"of the Patient Summary: e.g. a "human-curated" IPS Vs. an "automatically generated" IPS. Identifies who is responsible for the information in the composition, not necessarily who typed it in.
Control | 1..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Composition.title
Definition | Official human-readable label for the composition. For this document should be "International Patient Summary" or any equivalent translation
Control | 1..1
Type | string
Must Support | true
Summary | true
Comments | For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Composition.confidentiality
Definition | The code specifying the level of confidentiality of the Composition.
Control | 0..1
Binding | The codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26) Codes specifying the level of confidentiality of the composition.
Type | code
Must Support | true
Summary | true
Comments | The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Control | 0..*
Type | BackboneElement
Must Support | true
Summary | false
Requirements | Identifies responsibility for the accuracy of the composition content.
Comments | Only list each attester once.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Composition.attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. Composition.attester.mode
Definition | The type of attestation the authenticator offers.
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode The way in which a person authenticated a composition.
Type | code
Must Support | true
Summary | false
Requirements | Indicates the level of authority of the attestation.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Composition.attester.time
Definition | When the composition was attested by the party.
Control | 0..1
Type | dateTime
Must Support | true
Summary | false
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Composition.attester.party
Definition | Who attested the composition in the specified way.
Control | 0..1
Type | Reference(Patient|RelatedPerson|Practitioner|PractitionerRole|Organization)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Composition.custodian
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
Control | 0..1
Type | Reference(Organization)
Must Support | true
Summary | true
Requirements | Identifies where to go to find the current version, where to report issues, etc.
Comments | This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Composition.relatesTo
Definition | Relationships that this composition has with other compositions or documents that already exist.
Control | 0..*
Type | BackboneElement
Must Support | true
Summary | false
Comments | A document is a version specific composition.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Composition.relatesTo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
24. Composition.relatesTo.code
Definition | The type of relationship that this composition has with anther composition or document.
Control | 1..1
Binding | The codes SHALL be taken from DocumentRelationshipType The type of relationship between documents.
Type | code
Must Support | true
Summary | false
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Composition.relatesTo.target[x]
Definition | The target composition/document of this relationship.
Control | 1..1
Type | Choice of: Identifier, Reference(Composition|CompositionUvIps)
[x] Note | See Choice of Data Types for further information about how to use [x]
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Composition.event
Definition | The main activity being described by a IPS is the provision of healthcare over a period of time. In the CDA representation of the IPS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at lest one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the IPS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event. The clinical service, such as a colonoscopy or an appendectomy, being documented.
Control | 0..*
Type | BackboneElement
Must Support | true
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.event. The slices are unordered and Open, and can be differentiated using the following discriminators: pattern @ code
27. Composition.event.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. Composition.event:careProvisioningEvent
SliceName | careProvisioningEvent
Definition | The provision of healthcare over a period of time this IPS is documenting. The clinical service, such as a colonoscopy or an appendectomy, being documented.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Composition.event:careProvisioningEvent.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. Composition.event:careProvisioningEvent.code
Definition | This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Control | 10..*
Binding | For example codes, see v3 Code System ActCode This list of codes represents the main clinical acts being documented.
Type | CodeableConcept
Must Support | true
Summary | true
Comments | An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://terminology.hl7.org/CodeSystem/v3-ActClass"/> <code value="PCPR"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Composition.event:careProvisioningEvent.period
Definition | The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.
Control | 0..1
Type | Period
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Composition.section
Definition | The root of the sections that make up the IPS composition. The root of the sections that make up the composition.
Control | 30..*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators: pattern @ code
33. Composition.section.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
34. Composition.section:sectionMedications
SliceName | sectionMedications
Definition | The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report: the currently active medications; the current and past medications considered relevant by the authoring GP; the patient prescriptions or dispensations automatically extracted by a regional or a national EHR. In all those cases however medications are documented in the Patient Summary as medication statements. This section requires either an entry indicating the subject is known not to be on any relevant medication; either an entry indicating that no information is available about medications; or entries summarizing the subject's relevant medications. The root of the sections that make up the composition.
Control | 10..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Composition.section:sectionMedications.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
36. Composition.section:sectionMedications.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents. Medication Summary
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Composition.section:sectionMedications.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="10160-0"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Composition.section:sectionMedications.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Composition.section:sectionMedications.entry
Definition | This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication; either that no information is available about medications. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
40. Composition.section:sectionMedications.entry:medicationStatement
SliceName | medicationStatement
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationStatementIPS|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Composition.section:sectionMedications.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Composition.section:sectionMedications.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
43. Composition.section:sectionAllergies
SliceName | sectionAllergies
Definition | This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section. The root of the sections that make up the composition.
Control | 10..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Composition.section:sectionAllergies.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
45. Composition.section:sectionAllergies.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Composition.section:sectionAllergies.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="48765-2"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Composition.section:sectionAllergies.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Composition.section:sectionAllergies.entry
Definition | It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. This entry shall be used to document that no information about allergies is available, or that no allergies are known . A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
49. Composition.section:sectionAllergies.entry:allergyOrIntolerance
SliceName | allergyOrIntolerance
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntoleranceUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Composition.section:sectionAllergies.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Composition.section:sectionAllergies.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Composition.section:sectionProblems
SliceName | sectionProblems
Definition | The IPS problem section lists and describes clinical problems or conditions currently being monitored for the patient. The root of the sections that make up the composition.
Control | 10..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Composition.section:sectionProblems.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
54. Composition.section:sectionProblems.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. Composition.section:sectionProblems.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="11450-4"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. Composition.section:sectionProblems.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
58. Composition.section:sectionProblems.entry:problem
SliceName | problem
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Composition.section:sectionProblems.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. Composition.section:sectionProblems.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Composition.section:sectionProceduresHx
SliceName | sectionProceduresHx
Definition | The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to: Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section) Therapeutic procedure: e.g. dialysis; Surgical procedure: e.g. appendectomy The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. Composition.section:sectionProceduresHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
63. Composition.section:sectionProceduresHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. Composition.section:sectionProceduresHx.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="47519-4"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. Composition.section:sectionProceduresHx.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Composition.section:sectionProceduresHx.entry
Definition | It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to: Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section) Therapeutic procedure: e.g. dialysis; Surgical procedure: e.g. appendectomy. This entry shall be used to document that no information about past procedures is available, or that no relevant past procedures are known. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
67. Composition.section:sectionProceduresHx.entry:procedure
SliceName | procedure
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(ProcedureUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Composition.section:sectionProceduresHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. Composition.section:sectionProceduresHx.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. Composition.section:sectionImmunizations
SliceName | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. Composition.section:sectionImmunizations.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
72. Composition.section:sectionImmunizations.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Composition.section:sectionImmunizations.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="11369-6"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Composition.section:sectionImmunizations.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
76. Composition.section:sectionImmunizations.entry:immunization
SliceName | immunization
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(ImmunizationUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. Composition.section:sectionImmunizations.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. Composition.section:sectionImmunizations.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Composition.section:sectionMedicalDevices
SliceName | sectionMedicalDevices
Definition | The medical devices section contains narrative text and coded entries describing the patient history of medical device use. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Composition.section:sectionMedicalDevices.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
81. Composition.section:sectionMedicalDevices.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. Composition.section:sectionMedicalDevices.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="46264-8"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. Composition.section:sectionMedicalDevices.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. Composition.section:sectionMedicalDevices.entry
Definition | It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
85. Composition.section:sectionMedicalDevices.entry:deviceStatement
SliceName | deviceStatement
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatementUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
86. Composition.section:sectionMedicalDevices.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
87. Composition.section:sectionMedicalDevices.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
88. Composition.section:sectionResults
SliceName | sectionResults
Definition | This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
89. Composition.section:sectionResults.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
90. Composition.section:sectionResults.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Composition.section:sectionResults.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="30954-2"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. Composition.section:sectionResults.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
93. Composition.section:sectionResults.entry
Definition | Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: type @ $this.resolve() type @ $this.resolve(),
94. Composition.section:sectionResults.entry:results-observation
SliceName | results-observation
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationResultsLaboratoryUvIps|ObservationResultsPathologyUvIps|ObservationResultsRadiologyUvIps|ObservationResultsUvIps|Resource)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
95. Composition.section:sectionResults.entry:results-diagnosticReport
SliceName | results-diagnosticReport
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DiagnosticReportUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
96. Composition.section:sectionResults.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. Composition.section:sectionResults.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. Composition.section:sectionVitalSigns
SliceName | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. Composition.section:sectionVitalSigns.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
100. Composition.section:sectionVitalSigns.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
101. Composition.section:sectionVitalSigns.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="8716-3"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
102. Composition.section:sectionVitalSigns.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
103. Composition.section:sectionVitalSigns.entry
Definition | Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
104. Composition.section:sectionVitalSigns.entry:vitalSign
SliceName | vitalSign
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(observation-vitalsigns|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
105. Composition.section:sectionVitalSigns.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
106. Composition.section:sectionVitalSigns.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
107. Composition.section:sectionPastIllnessHx
SliceName | sectionPastIllnessHx
Definition | The History of Past Illness section contains a description of the conditions the patient suffered in the past. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. Composition.section:sectionPastIllnessHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
109. Composition.section:sectionPastIllnessHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
110. Composition.section:sectionPastIllnessHx.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="11348-0"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
111. Composition.section:sectionPastIllnessHx.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
112. Composition.section:sectionPastIllnessHx.entry
Definition | It contains a description of the conditions the patient suffered in the past. A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
113. Composition.section:sectionPastIllnessHx.entry:pastProblem
SliceName | pastProblem
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. Composition.section:sectionPastIllnessHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
115. Composition.section:sectionPastIllnessHx.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
116. Composition.section:sectionFunctionalStatus
SliceName | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
117. Composition.section:sectionFunctionalStatus.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
118. Composition.section:sectionFunctionalStatus.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
119. Composition.section:sectionFunctionalStatus.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="47420-5"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
120. Composition.section:sectionFunctionalStatus.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
121. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide. A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
122. Composition.section:sectionFunctionalStatus.entry:disability
SliceName | disability
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
123. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
SliceName | functionalAssessment
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ClinicalImpression|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
124. Composition.section:sectionFunctionalStatus.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
125. Composition.section:sectionFunctionalStatus.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
126. Composition.section:sectionPlanOfCare
SliceName | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
127. Composition.section:sectionPlanOfCare.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
128. Composition.section:sectionPlanOfCare.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
129. Composition.section:sectionPlanOfCare.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="18776-5"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
130. Composition.section:sectionPlanOfCare.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
131. Composition.section:sectionPlanOfCare.entry
Definition | Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940] A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
132. Composition.section:sectionPlanOfCare.entry:carePlan
SliceName | carePlan
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(CarePlan|Resource)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
133. Composition.section:sectionPlanOfCare.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
134. Composition.section:sectionPlanOfCare.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
135. Composition.section:sectionSocialHistory
SliceName | sectionSocialHistory
Definition | The social history section contains a description of the person’s Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.) The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
136. Composition.section:sectionSocialHistory.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
137. Composition.section:sectionSocialHistory.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
138. Composition.section:sectionSocialHistory.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="29762-2"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
139. Composition.section:sectionSocialHistory.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
140. Composition.section:sectionSocialHistory.entry
Definition | Description of the person’s Health related “lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.) A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
141. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
SliceName | smokingTobaccoUse
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationTobaccoUseUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
142. Composition.section:sectionSocialHistory.entry:alcoholUse
SliceName | alcoholUse
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationAlcoholUseUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
143. Composition.section:sectionSocialHistory.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
144. Composition.section:sectionSocialHistory.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
145. Composition.section:sectionPregnancyHx
SliceName | sectionPregnancyHx
Definition | The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
146. Composition.section:sectionPregnancyHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
147. Composition.section:sectionPregnancyHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
148. Composition.section:sectionPregnancyHx.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="10162-6"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
149. Composition.section:sectionPregnancyHx.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
150. Composition.section:sectionPregnancyHx.entry
Definition | It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies. A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
151. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
SliceName | pregnancyStatus
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationPregnancyStatusUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
152. Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
SliceName | pregnancyOutcomeSummary
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationPregnancyOutcomeUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
153. Composition.section:sectionPregnancyHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
154. Composition.section:sectionPregnancyHx.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
155. Composition.section:sectionAdvanceDirectives
SliceName | sectionAdvanceDirectives
Definition | The advance directives section contains a narrative description of patient's advance directive. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
156. Composition.section:sectionAdvanceDirectives.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
157. Composition.section:sectionAdvanceDirectives.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 10..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
158. Composition.section:sectionAdvanceDirectives.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="42348-3"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
159. Composition.section:sectionAdvanceDirectives.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
160. Composition.section:sectionAdvanceDirectives.entry
Definition | Contains a narrative description or a Consent entry with information about the patient's advance directive. A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
161. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
SliceName | advanceDirectivesConsent
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Consent|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
162. Composition.section:sectionAdvanceDirectives.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..01 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
163. Composition.section:sectionAdvanceDirectives.section
Definition | A nested sub-section within this section.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
164. Composition.section:sectionCertificationOfMedicalNecessity
SliceName | sectionCertificationOfMedicalNecessity
Definition | The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
165. Composition.section:sectionCertificationOfMedicalNecessity.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
166. Composition.section:sectionCertificationOfMedicalNecessity.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="52016-3"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
167. Composition.section:sectionCertificationOfMedicalNecessity.entry
Definition | Indication of whether a physician certification statement (PCS) is available documenting the medical necessity for the EMS encounter. The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature. A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
168. Composition.section:sectionCertificationOfMedicalNecessity.entry:MedicalNecessityEntry
SliceName | MedicalNecessityEntry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
169. Composition.section:sectionCertificationOfMedicalNecessity.entry:Signature
SliceName | Signature
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
170. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignatureDate
SliceName | SignatureDate
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
171. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignerProviderType
SliceName | SignerProviderType
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(PractitionerRole|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
172. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignerName
SliceName | SignerName
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Practitioner|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
173. Composition.section:sectionCertificationOfMedicalNecessity.entry:Justification
SliceName | Justification
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
174. Composition.section:sectionCertificationOfMedicalNecessity.entry:ReasonForTransport
SliceName | ReasonForTransport
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
175. Composition.section:sectionCertificationOfMedicalNecessity.entry:PriorAuthorizationCode
SliceName | PriorAuthorizationCode
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
176. Composition.section:sectionCertificationOfMedicalNecessity.entry:PriorAuthorizationCodePayer
SliceName | PriorAuthorizationCodePayer
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
177. Composition.section:sectionCoverage
SliceName | sectionCoverage
Definition | The insurance information for the patient to cover the encounter event. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
178. Composition.section:sectionCoverage.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
179. Composition.section:sectionCoverage.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="48768-6"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
180. Composition.section:sectionCoverage.entry
Definition | Contains data on the patient's payers, whether a 'third party' insurance, self-pay, other payer or guarantor, or some combination of payers, and is used to define which entity is the responsible fiduciary for the financial aspects of a patient's care A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Coverage|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
181. Composition.section:sectionCoverage.entry:Coverage
SliceName | Coverage
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
182. Composition.section:sectionReasonForReferral
SliceName | sectionReasonForReferral
Definition | This section shall include at least one entry describing the reason for referral as described in the Entry Content Module. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
183. Composition.section:sectionReasonForReferral.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
184. Composition.section:sectionReasonForReferral.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="42349-1"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
185. Composition.section:sectionReasonForReferral.entry
Definition | Indication of whether a physician certification statement (PCS) is available documenting the medical necessity for the EMS encounter. The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature. A reference to the actual resource from which the narrative in the section is derived.
Control | 20..2* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
186. Composition.section:sectionReasonForReferral.entry:SimpleObservations
SliceName | SimpleObservations
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..1* This element is affected by the following invariants: cmp-2
Type | Reference(Observation|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
187. Composition.section:sectionReasonForReferral.entry:ConditionsEntry
SliceName | ConditionsEntry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 10..1* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
188. Composition.section:sectionTransportInstructions
SliceName | sectionTransportInstructions
Definition | This section contains narrative information provided by the patient’s care provider(s) to indicate any care that should be rendered during the transport. The root of the sections that make up the composition.
Control | 0..1*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
189. Composition.section:sectionTransportInstructions.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
190. Composition.section:sectionTransportInstructions.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="74213-0"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
191. Composition.section:sectionTransportInstructions.entry
Definition | This section contains information provided by the patient’s care provider(s) to indicate any care that should be rendered during the transport and the Destination information. A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
192. Composition.section:sectionTransportInstructions.entry:TrasnportInstructions
SliceName | TrasnportInstructions
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
193. Composition.section:sectionTransportInstructions.entry:DestinationInformation
SliceName | DestinationInformation
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1* This element is affected by the following invariants: cmp-2
Type | Reference(Location|Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here.

1. Composition
Definition | International Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.
Control | 0..*
Must Support | true
Summary | false
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Composition.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Summary | true
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. Composition.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Composition.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Summary | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Composition.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages A human language
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Summary | false
Comments | 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).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Composition.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Must Support | true
Summary | false
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Composition.contained
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.
Control | 0..*
Type | Resource
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
8. Composition.extension
Definition | An Extension
Control | 0..*
Type | Extension
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Composition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
9. Composition.extension:versionNumber
SliceName | versionNumber
Definition | Version specific identifier for the composition, assigned when each version is created/updated.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(versionNumber) (Extension Type: string)
Comments | While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Composition.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Must Support | true
Summary | true
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Control | 1..1
Binding | The codes SHALL be taken from CompositionStatus The workflow/clinical status of the composition
Type | code
Is Modifier | true
Must Support | true
Summary | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Comments | If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Composition.type
Definition | Specifies that this composition refers to a Patient Summary (Loinc "60591-5")
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from FHIRDocumentTypeCodes Type of a composition
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="60591-5"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Composition.category
Definition | A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.
Control | 0..*
Binding | For example codes, see DocumentClassValueSet High-level kind of a clinical document at a macro level
Type | CodeableConcept
Summary | true
Requirements | Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.
Comments | This is a metadata field from XDS/MHD.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Composition.subject
Definition | Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the IPS the subject is always the patient.
Control | 1..1
Type | Reference(PatientUvIps)
Must Support | true
Summary | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Comments | For clinical documents, this is usually the patient.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Composition.subject.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
17. Composition.subject.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Composition.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
18. Composition.subject.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Control | 1..1 This element is affected by the following invariants: ref-1
Type | string
Must Support | true
Summary | true
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Composition.subject.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Control | 0..1
Binding | The codes SHALL be taken from ResourceType; other codes may be used where these codes are not suitable Aa resource (or, for logical models, the URI of the logical model)
Type | uri
Summary | true
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Composition.subject.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Composition.subject.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Control | 0..1
Type | string
Summary | true
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Composition.encounter
Definition | Describes the clinical encounter or type of care this documentation is associated with.
Control | 0..1
Type | Reference(Encounter)
Must Support | true
Summary | true
Requirements | Provides context for the composition and supports searching.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Control | 1..1
Type | dateTime
Must Support | true
Summary | true
Requirements | dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Composition.author
Definition | Identifies who is responsible for the information in the IPS, not necessarily who typed it in. The type of author(s) contribute to determine the "nature"of the Patient Summary: e.g. a "human-curated" IPS Vs. an "automatically generated" IPS.
Control | 1..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Composition.title
Definition | Official human-readable label for the composition. For this document should be "International Patient Summary" or any equivalent translation
Control | 1..1
Type | string
Must Support | true
Summary | true
Comments | For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Composition.confidentiality
Definition | The code specifying the level of confidentiality of the Composition.
Control | 0..1
Binding | The codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26) Codes specifying the level of confidentiality of the composition
Type | code
Must Support | true
Summary | true
Comments | The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Control | 0..*
Type | BackboneElement
Must Support | true
Summary | false
Requirements | Identifies responsibility for the accuracy of the composition content.
Comments | Only list each attester once.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Composition.attester.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
29. Composition.attester.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. Composition.attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
31. Composition.attester.mode
Definition | The type of attestation the authenticator offers.
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode The way in which a person authenticated a composition
Type | code
Must Support | true
Summary | false
Requirements | Indicates the level of authority of the attestation.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Composition.attester.time
Definition | When the composition was attested by the party.
Control | 0..1
Type | dateTime
Must Support | true
Summary | false
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. Composition.attester.party
Definition | Who attested the composition in the specified way.
Control | 0..1
Type | Reference(Patient|RelatedPerson|Practitioner|PractitionerRole|Organization)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Composition.custodian
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
Control | 0..1
Type | Reference(Organization)
Must Support | true
Summary | true
Requirements | Identifies where to go to find the current version, where to report issues, etc.
Comments | This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Composition.relatesTo
Definition | Relationships that this composition has with other compositions or documents that already exist.
Control | 0..*
Type | BackboneElement
Must Support | true
Summary | false
Comments | A document is a version specific composition.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Composition.relatesTo.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
37. Composition.relatesTo.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
38. Composition.relatesTo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
39. Composition.relatesTo.code
Definition | The type of relationship that this composition has with anther composition or document.
Control | 1..1
Binding | The codes SHALL be taken from DocumentRelationshipType The type of relationship between documents
Type | code
Must Support | true
Summary | false
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Composition.relatesTo.target[x]
Definition | The target composition/document of this relationship.
Control | 1..1
Type | Choice of: Identifier, Reference(Composition|CompositionUvIps)
[x] Note | See Choice of Data Types for further information about how to use [x]
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Composition.event
Definition | The main activity being described by a IPS is the provision of healthcare over a period of time. In the CDA representation of the IPS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at lest one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the IPS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event.
Control | 0..*
Type | BackboneElement
Must Support | true
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.event. The slices are unordered and Open, and can be differentiated using the following discriminators: pattern @ code
42. Composition.event.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
43. Composition.event.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
44. Composition.event.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
45. Composition.event.code
Definition | This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Control | 0..*
Binding | For example codes, see v3 Code System ActCode This list of codes represents the main clinical acts being documented
Type | CodeableConcept
Summary | true
Comments | An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Composition.event.period
Definition | The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.
Control | 0..1
Type | Period
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Composition.event.detail
Definition | The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.
Control | 0..*
Type | Reference(Resource)
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Composition.event:careProvisioningEvent
SliceName | careProvisioningEvent
Definition | The provision of healthcare over a period of time this IPS is documenting.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Composition.event:careProvisioningEvent.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
50. Composition.event:careProvisioningEvent.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
51. Composition.event:careProvisioningEvent.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
52. Composition.event:careProvisioningEvent.code
Definition | This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Control | 1..*
Binding | For example codes, see v3 Code System ActCode This list of codes represents the main clinical acts being documented
Type | CodeableConcept
Must Support | true
Summary | true
Comments | An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://terminology.hl7.org/CodeSystem/v3-ActClass"/> <code value="PCPR"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Composition.event:careProvisioningEvent.period
Definition | The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.
Control | 0..1
Type | Period
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Composition.event:careProvisioningEvent.detail
Definition | The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.
Control | 0..*
Type | Reference(Resource)
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. Composition.section
Definition | The root of the sections that make up the IPS composition.
Control | 3..*
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators: pattern @ code
56. Composition.section.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
57. Composition.section.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
58. Composition.section.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
59. Composition.section.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 0..1
Type | string
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. Composition.section.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 0..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Composition.section.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. Composition.section.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. Composition.section.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. Composition.section.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. Composition.section.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Composition.section.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Composition.section.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Composition.section.section
Definition | A nested sub-section within this section.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. Composition.section:sectionMedications
SliceName | sectionMedications
Definition | The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report: the currently active medications; the current and past medications considered relevant by the authoring GP; the patient prescriptions or dispensations automatically extracted by a regional or a national EHR. In all those cases however medications are documented in the Patient Summary as medication statements. This section requires either an entry indicating the subject is known not to be on any relevant medication; either an entry indicating that no information is available about medications; or entries summarizing the subject's relevant medications.
Control | 1..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. Composition.section:sectionMedications.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
71. Composition.section:sectionMedications.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
72. Composition.section:sectionMedications.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
73. Composition.section:sectionMedications.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents. Medication Summary
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Composition.section:sectionMedications.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="10160-0"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. Composition.section:sectionMedications.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. Composition.section:sectionMedications.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. Composition.section:sectionMedications.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. Composition.section:sectionMedications.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Composition.section:sectionMedications.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Composition.section:sectionMedications.entry
Definition | This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication; either that no information is available about medications.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
81. Composition.section:sectionMedications.entry:medicationStatement
SliceName | medicationStatement
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationStatementIPS)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. Composition.section:sectionMedications.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. Composition.section:sectionMedications.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. Composition.section:sectionAllergies
SliceName | sectionAllergies
Definition | This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Control | 1..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
85. Composition.section:sectionAllergies.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
86. Composition.section:sectionAllergies.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
87. Composition.section:sectionAllergies.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
88. Composition.section:sectionAllergies.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
89. Composition.section:sectionAllergies.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="48765-2"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
90. Composition.section:sectionAllergies.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Composition.section:sectionAllergies.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. Composition.section:sectionAllergies.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
93. Composition.section:sectionAllergies.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
94. Composition.section:sectionAllergies.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
95. Composition.section:sectionAllergies.entry
Definition | It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. This entry shall be used to document that no information about allergies is available, or that no allergies are known .
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
96. Composition.section:sectionAllergies.entry:allergyOrIntolerance
SliceName | allergyOrIntolerance
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntoleranceUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. Composition.section:sectionAllergies.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. Composition.section:sectionAllergies.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. Composition.section:sectionProblems
SliceName | sectionProblems
Definition | The IPS problem section lists and describes clinical problems or conditions currently being monitored for the patient.
Control | 1..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
100. Composition.section:sectionProblems.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
101. Composition.section:sectionProblems.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
102. Composition.section:sectionProblems.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
103. Composition.section:sectionProblems.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
104. Composition.section:sectionProblems.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="11450-4"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
105. Composition.section:sectionProblems.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
106. Composition.section:sectionProblems.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
107. Composition.section:sectionProblems.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. Composition.section:sectionProblems.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
109. Composition.section:sectionProblems.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
110. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
111. Composition.section:sectionProblems.entry:problem
SliceName | problem
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
112. Composition.section:sectionProblems.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
113. Composition.section:sectionProblems.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. Composition.section:sectionProceduresHx
SliceName | sectionProceduresHx
Definition | The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to: Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section) Therapeutic procedure: e.g. dialysis; Surgical procedure: e.g. appendectomy
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
115. Composition.section:sectionProceduresHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
116. Composition.section:sectionProceduresHx.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
117. Composition.section:sectionProceduresHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
118. Composition.section:sectionProceduresHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
119. Composition.section:sectionProceduresHx.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="47519-4"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
120. Composition.section:sectionProceduresHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
121. Composition.section:sectionProceduresHx.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
122. Composition.section:sectionProceduresHx.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
123. Composition.section:sectionProceduresHx.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
124. Composition.section:sectionProceduresHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
125. Composition.section:sectionProceduresHx.entry
Definition | It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to: Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section) Therapeutic procedure: e.g. dialysis; Surgical procedure: e.g. appendectomy. This entry shall be used to document that no information about past procedures is available, or that no relevant past procedures are known.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
126. Composition.section:sectionProceduresHx.entry:procedure
SliceName | procedure
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(ProcedureUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
127. Composition.section:sectionProceduresHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
128. Composition.section:sectionProceduresHx.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
129. Composition.section:sectionImmunizations
SliceName | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
130. Composition.section:sectionImmunizations.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
131. Composition.section:sectionImmunizations.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
132. Composition.section:sectionImmunizations.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
133. Composition.section:sectionImmunizations.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
134. Composition.section:sectionImmunizations.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="11369-6"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
135. Composition.section:sectionImmunizations.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
136. Composition.section:sectionImmunizations.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
137. Composition.section:sectionImmunizations.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
138. Composition.section:sectionImmunizations.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
139. Composition.section:sectionImmunizations.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
140. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
141. Composition.section:sectionImmunizations.entry:immunization
SliceName | immunization
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(ImmunizationUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
142. Composition.section:sectionImmunizations.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
143. Composition.section:sectionImmunizations.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
144. Composition.section:sectionMedicalDevices
SliceName | sectionMedicalDevices
Definition | The medical devices section contains narrative text and coded entries describing the patient history of medical device use.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
145. Composition.section:sectionMedicalDevices.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
146. Composition.section:sectionMedicalDevices.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
147. Composition.section:sectionMedicalDevices.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
148. Composition.section:sectionMedicalDevices.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
149. Composition.section:sectionMedicalDevices.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="46264-8"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
150. Composition.section:sectionMedicalDevices.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
151. Composition.section:sectionMedicalDevices.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
152. Composition.section:sectionMedicalDevices.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
153. Composition.section:sectionMedicalDevices.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
154. Composition.section:sectionMedicalDevices.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
155. Composition.section:sectionMedicalDevices.entry
Definition | It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
156. Composition.section:sectionMedicalDevices.entry:deviceStatement
SliceName | deviceStatement
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatementUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
157. Composition.section:sectionMedicalDevices.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
158. Composition.section:sectionMedicalDevices.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
159. Composition.section:sectionResults
SliceName | sectionResults
Definition | This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
160. Composition.section:sectionResults.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
161. Composition.section:sectionResults.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
162. Composition.section:sectionResults.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
163. Composition.section:sectionResults.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
164. Composition.section:sectionResults.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="30954-2"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
165. Composition.section:sectionResults.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
166. Composition.section:sectionResults.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
167. Composition.section:sectionResults.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
168. Composition.section:sectionResults.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
169. Composition.section:sectionResults.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
170. Composition.section:sectionResults.entry
Definition | Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: type @ $this.resolve() type @ $this.resolve(),
171. Composition.section:sectionResults.entry:results-observation
SliceName | results-observation
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationResultsLaboratoryUvIps|ObservationResultsPathologyUvIps|ObservationResultsRadiologyUvIps|ObservationResultsUvIps)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
172. Composition.section:sectionResults.entry:results-diagnosticReport
SliceName | results-diagnosticReport
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DiagnosticReportUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
173. Composition.section:sectionResults.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
174. Composition.section:sectionResults.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
175. Composition.section:sectionVitalSigns
SliceName | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
176. Composition.section:sectionVitalSigns.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
177. Composition.section:sectionVitalSigns.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
178. Composition.section:sectionVitalSigns.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
179. Composition.section:sectionVitalSigns.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
180. Composition.section:sectionVitalSigns.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="8716-3"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
181. Composition.section:sectionVitalSigns.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
182. Composition.section:sectionVitalSigns.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
183. Composition.section:sectionVitalSigns.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
184. Composition.section:sectionVitalSigns.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
185. Composition.section:sectionVitalSigns.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
186. Composition.section:sectionVitalSigns.entry
Definition | Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
187. Composition.section:sectionVitalSigns.entry:vitalSign
SliceName | vitalSign
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(observation-vitalsigns)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
188. Composition.section:sectionVitalSigns.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
189. Composition.section:sectionVitalSigns.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
190. Composition.section:sectionPastIllnessHx
SliceName | sectionPastIllnessHx
Definition | The History of Past Illness section contains a description of the conditions the patient suffered in the past.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
191. Composition.section:sectionPastIllnessHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
192. Composition.section:sectionPastIllnessHx.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
193. Composition.section:sectionPastIllnessHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
194. Composition.section:sectionPastIllnessHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
195. Composition.section:sectionPastIllnessHx.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="11348-0"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
196. Composition.section:sectionPastIllnessHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
197. Composition.section:sectionPastIllnessHx.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
198. Composition.section:sectionPastIllnessHx.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
199. Composition.section:sectionPastIllnessHx.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
200. Composition.section:sectionPastIllnessHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
201. Composition.section:sectionPastIllnessHx.entry
Definition | It contains a description of the conditions the patient suffered in the past.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
202. Composition.section:sectionPastIllnessHx.entry:pastProblem
SliceName | pastProblem
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
203. Composition.section:sectionPastIllnessHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
204. Composition.section:sectionPastIllnessHx.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
205. Composition.section:sectionFunctionalStatus
SliceName | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
206. Composition.section:sectionFunctionalStatus.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
207. Composition.section:sectionFunctionalStatus.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
208. Composition.section:sectionFunctionalStatus.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
209. Composition.section:sectionFunctionalStatus.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
210. Composition.section:sectionFunctionalStatus.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="47420-5"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
211. Composition.section:sectionFunctionalStatus.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
212. Composition.section:sectionFunctionalStatus.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
213. Composition.section:sectionFunctionalStatus.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
214. Composition.section:sectionFunctionalStatus.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
215. Composition.section:sectionFunctionalStatus.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
216. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
217. Composition.section:sectionFunctionalStatus.entry:disability
SliceName | disability
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
218. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
SliceName | functionalAssessment
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ClinicalImpression)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
219. Composition.section:sectionFunctionalStatus.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
220. Composition.section:sectionFunctionalStatus.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
221. Composition.section:sectionPlanOfCare
SliceName | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
222. Composition.section:sectionPlanOfCare.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
223. Composition.section:sectionPlanOfCare.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
224. Composition.section:sectionPlanOfCare.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
225. Composition.section:sectionPlanOfCare.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
226. Composition.section:sectionPlanOfCare.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="18776-5"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
227. Composition.section:sectionPlanOfCare.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
228. Composition.section:sectionPlanOfCare.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
229. Composition.section:sectionPlanOfCare.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
230. Composition.section:sectionPlanOfCare.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
231. Composition.section:sectionPlanOfCare.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
232. Composition.section:sectionPlanOfCare.entry
Definition | Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
233. Composition.section:sectionPlanOfCare.entry:carePlan
SliceName | carePlan
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(CarePlan)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
234. Composition.section:sectionPlanOfCare.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
235. Composition.section:sectionPlanOfCare.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
236. Composition.section:sectionSocialHistory
SliceName | sectionSocialHistory
Definition | The social history section contains a description of the person’s Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
237. Composition.section:sectionSocialHistory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
238. Composition.section:sectionSocialHistory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
239. Composition.section:sectionSocialHistory.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
240. Composition.section:sectionSocialHistory.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
241. Composition.section:sectionSocialHistory.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="29762-2"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
242. Composition.section:sectionSocialHistory.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
243. Composition.section:sectionSocialHistory.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
244. Composition.section:sectionSocialHistory.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
245. Composition.section:sectionSocialHistory.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
246. Composition.section:sectionSocialHistory.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
247. Composition.section:sectionSocialHistory.entry
Definition | Description of the person’s Health related “lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
248. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
SliceName | smokingTobaccoUse
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(ObservationTobaccoUseUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
249. Composition.section:sectionSocialHistory.entry:alcoholUse
SliceName | alcoholUse
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(ObservationAlcoholUseUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
250. Composition.section:sectionSocialHistory.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
251. Composition.section:sectionSocialHistory.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
252. Composition.section:sectionPregnancyHx
SliceName | sectionPregnancyHx
Definition | The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
253. Composition.section:sectionPregnancyHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
254. Composition.section:sectionPregnancyHx.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
255. Composition.section:sectionPregnancyHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
256. Composition.section:sectionPregnancyHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
257. Composition.section:sectionPregnancyHx.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="10162-6"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
258. Composition.section:sectionPregnancyHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
259. Composition.section:sectionPregnancyHx.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
260. Composition.section:sectionPregnancyHx.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
261. Composition.section:sectionPregnancyHx.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
262. Composition.section:sectionPregnancyHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
263. Composition.section:sectionPregnancyHx.entry
Definition | It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
264. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
SliceName | pregnancyStatus
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationPregnancyStatusUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
265. Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
SliceName | pregnancyOutcomeSummary
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ObservationPregnancyOutcomeUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
266. Composition.section:sectionPregnancyHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
267. Composition.section:sectionPregnancyHx.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
268. Composition.section:sectionAdvanceDirectives
SliceName | sectionAdvanceDirectives
Definition | The advance directives section contains a narrative description of patient's advance directive.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
269. Composition.section:sectionAdvanceDirectives.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
270. Composition.section:sectionAdvanceDirectives.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
271. Composition.section:sectionAdvanceDirectives.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
272. Composition.section:sectionAdvanceDirectives.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 1..1
Type | string
Must Support | true
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
273. Composition.section:sectionAdvanceDirectives.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept(CodeableConceptIPS)
Must Support | true
Requirements | Provides computable standardized labels to topics within the document.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="42348-3"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
274. Composition.section:sectionAdvanceDirectives.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
275. Composition.section:sectionAdvanceDirectives.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
276. Composition.section:sectionAdvanceDirectives.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Must Support | true
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
277. Composition.section:sectionAdvanceDirectives.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
278. Composition.section:sectionAdvanceDirectives.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
279. Composition.section:sectionAdvanceDirectives.entry
Definition | Contains a narrative description or a Consent entry with information about the patient's advance directive.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
280. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
SliceName | advanceDirectivesConsent
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Consent)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
281. Composition.section:sectionAdvanceDirectives.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..0 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
282. Composition.section:sectionAdvanceDirectives.section
Definition | A nested sub-section within this section.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
283. Composition.section:sectionCertificationOfMedicalNecessity
SliceName | sectionCertificationOfMedicalNecessity
Definition | The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
284. Composition.section:sectionCertificationOfMedicalNecessity.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
285. Composition.section:sectionCertificationOfMedicalNecessity.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
286. Composition.section:sectionCertificationOfMedicalNecessity.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
287. Composition.section:sectionCertificationOfMedicalNecessity.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 0..1
Type | string
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
288. Composition.section:sectionCertificationOfMedicalNecessity.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="52016-3"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
289. Composition.section:sectionCertificationOfMedicalNecessity.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
290. Composition.section:sectionCertificationOfMedicalNecessity.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
291. Composition.section:sectionCertificationOfMedicalNecessity.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
292. Composition.section:sectionCertificationOfMedicalNecessity.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
293. Composition.section:sectionCertificationOfMedicalNecessity.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
294. Composition.section:sectionCertificationOfMedicalNecessity.entry
Definition | Indication of whether a physician certification statement (PCS) is available documenting the medical necessity for the EMS encounter. The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
295. Composition.section:sectionCertificationOfMedicalNecessity.entry:MedicalNecessityEntry
SliceName | MedicalNecessityEntry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
296. Composition.section:sectionCertificationOfMedicalNecessity.entry:Signature
SliceName | Signature
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
297. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignatureDate
SliceName | SignatureDate
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
298. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignerProviderType
SliceName | SignerProviderType
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(PractitionerRole)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
299. Composition.section:sectionCertificationOfMedicalNecessity.entry:SignerName
SliceName | SignerName
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Practitioner)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
300. Composition.section:sectionCertificationOfMedicalNecessity.entry:Justification
SliceName | Justification
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
301. Composition.section:sectionCertificationOfMedicalNecessity.entry:ReasonForTransport
SliceName | ReasonForTransport
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
302. Composition.section:sectionCertificationOfMedicalNecessity.entry:PriorAuthorizationCode
SliceName | PriorAuthorizationCode
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
303. Composition.section:sectionCertificationOfMedicalNecessity.entry:PriorAuthorizationCodePayer
SliceName | PriorAuthorizationCodePayer
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
304. Composition.section:sectionCertificationOfMedicalNecessity.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
305. Composition.section:sectionCertificationOfMedicalNecessity.section
Definition | A nested sub-section within this section.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
306. Composition.section:sectionCoverage
SliceName | sectionCoverage
Definition | The insurance information for the patient to cover the encounter event.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
307. Composition.section:sectionCoverage.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
308. Composition.section:sectionCoverage.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
309. Composition.section:sectionCoverage.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
310. Composition.section:sectionCoverage.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 0..1
Type | string
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
311. Composition.section:sectionCoverage.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="48768-6"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
312. Composition.section:sectionCoverage.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
313. Composition.section:sectionCoverage.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
314. Composition.section:sectionCoverage.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
315. Composition.section:sectionCoverage.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
316. Composition.section:sectionCoverage.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
317. Composition.section:sectionCoverage.entry
Definition | Contains data on the patient's payers, whether a 'third party' insurance, self-pay, other payer or guarantor, or some combination of payers, and is used to define which entity is the responsible fiduciary for the financial aspects of a patient's care
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Coverage)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
318. Composition.section:sectionCoverage.entry:Coverage
SliceName | Coverage
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
319. Composition.section:sectionCoverage.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
320. Composition.section:sectionCoverage.section
Definition | A nested sub-section within this section.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
321. Composition.section:sectionReasonForReferral
SliceName | sectionReasonForReferral
Definition | This section shall include at least one entry describing the reason for referral as described in the Entry Content Module.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
322. Composition.section:sectionReasonForReferral.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
323. Composition.section:sectionReasonForReferral.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
324. Composition.section:sectionReasonForReferral.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
325. Composition.section:sectionReasonForReferral.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 0..1
Type | string
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
326. Composition.section:sectionReasonForReferral.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="42349-1"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
327. Composition.section:sectionReasonForReferral.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
328. Composition.section:sectionReasonForReferral.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
329. Composition.section:sectionReasonForReferral.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
330. Composition.section:sectionReasonForReferral.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
331. Composition.section:sectionReasonForReferral.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
332. Composition.section:sectionReasonForReferral.entry
Definition | Indication of whether a physician certification statement (PCS) is available documenting the medical necessity for the EMS encounter. The Certification of Medical Necessity section includes the information necessary to document the justification for the medical transport, including the name and role of the person authorizing the medical transport. This information can be used to generate a Certificate of Medical Necessity (CMN) document for signature.
Control | 2..2 This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
333. Composition.section:sectionReasonForReferral.entry:SimpleObservations
SliceName | SimpleObservations
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..1 This element is affected by the following invariants: cmp-2
Type | Reference(Observation)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
334. Composition.section:sectionReasonForReferral.entry:ConditionsEntry
SliceName | ConditionsEntry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 1..1 This element is affected by the following invariants: cmp-2
Type | Reference(ConditionUvIps)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
335. Composition.section:sectionReasonForReferral.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
336. Composition.section:sectionReasonForReferral.section
Definition | A nested sub-section within this section.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
337. Composition.section:sectionTransportInstructions
SliceName | sectionTransportInstructions
Definition | This section contains narrative information provided by the patient’s care provider(s) to indicate any care that should be rendered during the transport.
Control | 0..1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
338. Composition.section:sectionTransportInstructions.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
339. Composition.section:sectionTransportInstructions.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
340. Composition.section:sectionTransportInstructions.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
341. Composition.section:sectionTransportInstructions.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 0..1
Type | string
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
342. Composition.section:sectionTransportInstructions.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document
Type | CodeableConcept
Must Support | true
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://loinc.org"/> <code value="74213-0"/> </coding> </valueCodeableConcept>
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
343. Composition.section:sectionTransportInstructions.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner|PractitionerRole|Device|Patient|RelatedPerson|Organization)
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
344. Composition.section:sectionTransportInstructions.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Summary | false
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
345. Composition.section:sectionTransportInstructions.text
Definition | A human-readable narrative that contains the attested content of the section, 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.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Summary | false
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
346. Composition.section:sectionTransportInstructions.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section
Type | code
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
347. Composition.section:sectionTransportInstructions.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry
Type | CodeableConcept
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
348. Composition.section:sectionTransportInstructions.entry
Definition | This section contains information provided by the patient’s care provider(s) to indicate any care that should be rendered during the transport and the Destination information.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
349. Composition.section:sectionTransportInstructions.entry:TrasnportInstructions
SliceName | TrasnportInstructions
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
350. Composition.section:sectionTransportInstructions.entry:DestinationInformation
SliceName | DestinationInformation
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..1 This element is affected by the following invariants: cmp-2
Type | Reference(Location)
Must Support | true
Summary | false
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
351. Composition.section:sectionTransportInstructions.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty
Type | CodeableConcept
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
352. Composition.section:sectionTransportInstructions.section
Definition | A nested sub-section within this section.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Summary | false
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))