ehealth-definedquestion
type: StructureDefinition
node role: treeRoot
id:
  v: ehealth-definedquestion
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition ehealth-definedquestion Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> StructureDefinition 0..* StructureDefinition Structural Definition #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
url:
  v: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-definedquestion
  l: ehealth-definedquestion
version:
  v: 7.0.0
name:
  v: ehealth-definedquestion
status:
  v: active
date:
  v: 2025-12-02T12:53:58+00:00
publisher:
  v: Den telemedicinske infrastruktur (eHealth Infrastructure)
contact:
  name:
    v: Den telemedicinske infrastruktur (eHealth Infrastructure)
  telecom:
    system:
      v: url
    value:
      v: http://ehealth.sundhed.dk
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
      l: 3166
    code:
      v: DK
    display:
      v: Denmark
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
mapping:
  identity:
    v: workflow
  uri:
    v: http://hl7.org/fhir/workflow
    l: workflow
  name:
    v: Workflow Pattern
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
    l: fivews
  name:
    v: FiveWs Pattern Mapping
mapping:
  identity:
    v: iso11179
  uri:
    v: http://metadata-standards.org/11179/
    l: http://metadata-standards.org/11179/
  name:
    v: ISO 11179
mapping:
  identity:
    v: objimpl
  uri:
    v: http://hl7.org/fhir/object-implementation
    l: object-implementation
  name:
    v: Object Implementation Information
kind:
  v: resource
abstract:
  v: false
type:
  v: StructureDefinition
  l: StructureDefinition
base definition:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: StructureDefinition
    path:
      v: StructureDefinition
    short:
      v: Structural Definition
    definition:
      v: A definition of a FHIR structure. This resource is used to describe the underlying resources, data types defined in FHIR, and also for describing extensions and constraints on resources and data types.
    alias:
      v: Template
    alias:
      v: Profile
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: StructureDefinition
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
      expression:
        v: 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()
      xpath:
        v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:security))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      extension:
        value: Boolean
      extension:
        value: Markdown
      key:
        v: dom-6
      severity:
        v: warning
      human:
        v: A resource should have narrative for robust management
      expression:
        v: text.`div`.exists()
      xpath:
        v: exists(f:text/h:div)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: sdf-0
      severity:
        v: warning

Boolean
v: true

Markdown
v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

v: Name should be usable as an identifier for the module by machine processing applications such as code generation

v: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')

v: not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')

key:
  v: sdf-1
severity:
  v: error
human:
  v: Element paths must be unique unless the structure is a constraint
expression:
  v: derivation = 'constraint' or snapshot.element.select(path).isDistinct()
xpath:
  v: (f:derivation/@value = 'constraint') or (count(f:snapshot/f:element) = count(distinct-values(f:snapshot/f:element/f:path/@value)))
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-15a
requirements:
  v: No Type on the root element (differential)
severity:
  v: error
human:
  v: If the first element in a differential has no "." in the path and it's not a logical model, it has no type
expression:
  v: (kind!='logical' and differential.element.first().path.contains('.').not()) implies differential.element.first().type.empty()
xpath:
  v: f:kind/@value='logical' or not(f:differential/f:element[1][not(contains(f:path/@value, '.'))]/f:type)
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-4
requirements:
  v: Ensure that the base types are abstract
severity:
  v: error
human:
  v: If the structure is not abstract, then there SHALL be a baseDefinition
expression:
  v: abstract = true or baseDefinition.exists()
xpath:
  v: (f:abstract/@value=true()) or exists(f:baseDefinition)
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-5
severity:
  v: error
human:
  v: If the structure defines an extension then the structure must have context information
expression:
  v: type != 'Extension' or derivation = 'specialization' or (context.exists())
xpath:
  v: not(f:type/@value = 'extension') or (f:derivation/@value = 'specialization') or (exists(f:context))
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-6
severity:
  v: error
human:
  v: A structure must have either a differential, or a snapshot (or both)
expression:
  v: snapshot.exists() or differential.exists()
xpath:
  v: exists(f:snapshot) or exists(f:differential)
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-9
requirements:
  v: Because these 3 fields seem to be have overlapping meaning with the ones in the root of StructureDefinition
severity:
  v: error
human:
  v: In any snapshot or differential, no label, code or requirements on an element without a "." in the path (e.g. the first element)
expression:
  v: children().element.where(path.contains('.').not()).label.empty() and children().element.where(path.contains('.').not()).code.empty() and children().element.where(path.contains('.').not()).requirements.empty()
xpath:
  v: not(exists(f:snapshot/f:element[not(contains(f:path/@value, '.')) and (f:label or f:code or f:requirements)])) and not(exists(f:differential/f:element[not(contains(f:path/@value, '.')) and (f:label or f:code or f:requirements)]))
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-11
requirements:
  v: Ensure that the type is not inconsistent with the other information in the structure
severity:
  v: error
human:
  v: If there's a type, its content must match the path name in the first element of a snapshot
expression:
  v: kind != 'logical' implies snapshot.empty() or snapshot.element.first().path = type
xpath:
  v: (f:kind/@value = 'logical') or not(exists(f:snapshot)) or (f:type/@value = f:snapshot/f:element[1]/f:path/@value)
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-14
requirements:
  v: elements have id
severity:
  v: error
human:
  v: All element definitions must have an id
expression:
  v: snapshot.element.all(id.exists()) and differential.element.all(id.exists())
xpath:
  v: count(*/f:element)=count(*/f:element/@id)
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-15
requirements:
  v: No Type on the root element (snapshot)
severity:
  v: error
human:
  v: The first element in a snapshot has no type unless model is a logical model.
expression:
  v: kind!='logical' implies snapshot.element.first().type.empty()
xpath:
  v: f:kind/@value='logical' or not(f:snapshot/f:element[1]/f:type)
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-16
requirements:
  v: element ids need to be unique
severity:
  v: error
human:
  v: All element definitions must have unique ids (snapshot)
expression:
  v: snapshot.element.all(id.exists()) and snapshot.element.id.trace('ids').isDistinct()
xpath:
  v: count(f:snapshot/f:element)=count(f:snapshot/f:element/@id) and (count(f:snapshot/f:element)=count(distinct-values(f:snapshot/f:element/@id)))
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-17
requirements:
  v: element ids need to be unique
severity:
  v: error
human:
  v: All element definitions must have unique ids (diff)
expression:
  v: differential.element.all(id.exists()) and differential.element.id.trace('ids').isDistinct()
xpath:
  v: count(f:differential/f:element)=count(f:differential/f:element/@id) and (count(f:differential/f:element)=count(distinct-values(f:differential/f:element/@id)))
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-18
requirements:
  v: contextInvariant
severity:
  v: error
human:
  v: Context Invariants can only be used for extensions
expression:
  v: contextInvariant.exists() implies type = 'Extension'
xpath:
  v: not(exists(f:contextInvariant)) or (f:type/@value = 'Extension')
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-19
requirements:
  v: custom types only in logical models
severity:
  v: error
human:
  v: FHIR Specification models only use FHIR defined types
expression:
  v: url.startsWith('http://hl7.org/fhir/StructureDefinition') implies (differential.element.type.code.all(matches('^[a-zA-Z0-9]+$') or matches('^http:\\/\\/hl7\\.org\\/fhirpath\\/System\\.[A-Z][A-Za-z]+$')) and snapshot.element.type.code.all(matches('^[a-zA-Z0-9\\.]+$') or matches('^http:\\/\\/hl7\\.org\\/fhirpath\\/System\\.[A-Z][A-Za-z]+$')))
xpath:
  v: not(starts-with(f:url/@value, 'http://hl7.org/fhir/StructureDefinition')) or count(f:differential/f:element/f:type/f:code[@value and not(matches(string(@value), '^[a-zA-Z0-9\.]+$'))]|f:snapshot/f:element/f:type/f:code[@value and not(matches(string(@value), '^[a-zA-Z0-9]+$\.'))]) =0
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-21
requirements:
  v: no default values on data types or resources
severity:
  v: error
human:
  v: Default values can only be specified on specializations
expression:
  v: differential.element.defaultValue.exists() implies (derivation = 'specialization')
xpath:
  v: not(exists(f:differential/f:element/*[starts-with(local-name(), 'defaultValue')])) or (f:derivation/@value = 'specialization')
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-22
requirements:
  v: no default values on data types or resources
severity:
  v: error
human:
  v: FHIR Specification models never have default values
expression:
  v: url.startsWith('http://hl7.org/fhir/StructureDefinition') implies (snapshot.element.defaultValue.empty() and differential.element.defaultValue.empty())
xpath:
  v: not(starts-with(f:url/@value, 'http://hl7.org/fhir/StructureDefinition')) or (not(exists(f:snapshot/f:element/*[starts-with(local-name(), 'defaultValue')])) and not(exists(f:differential/f:element/*[starts-with(local-name(), 'defaultValue')])))
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

key:
  v: sdf-23
requirements:
  v: no sliceName on root
severity:
  v: error
human:
  v: No slice name on root
expression:
  v: (snapshot | differential).element.all(path.contains('.').not() implies sliceName.empty())
xpath:
  v: count(*[self::snapshot or self::differential]/f:element[not(contains(f:path/@value, '.')) and f:sliceName])=0
source:
  v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
  l: StructureDefinition

v: false

v: false

identity:
  v: rim
map:
  v: Entity. Role, or Act

identity:
  v: rim
map:
  v: n/a

id:
  v: StructureDefinition.id
path:
  v: StructureDefinition.id
short:
  v: Logical id of this artifact
definition:
  v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
comment:
  v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: true

id:
  v: StructureDefinition.meta
path:
  v: StructureDefinition.meta
short:
  v: Metadata about the resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
    l: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: StructureDefinition.implicitRules
path:
  v: StructureDefinition.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
is summary:
  v: true

id:
  v: StructureDefinition.language
path:
  v: StructureDefinition.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      l: all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages|4.0.1
    l: http://hl7.org/fhir/ValueSet/languages

id:
  v: StructureDefinition.text
path:
  v: StructureDefinition.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: StructureDefinition.contained
path:
  v: StructureDefinition.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: StructureDefinition.extension
path:
  v: StructureDefinition.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: StructureDefinition.modifierExtension
path:
  v: StructureDefinition.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: 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).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: StructureDefinition.url
path:
  v: StructureDefinition.url
short:
  v: Canonical identifier for this structure definition, represented as a URI (globally unique)
definition:
  v: An absolute URI that is used to identify this structure definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this structure definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the structure definition is stored on different servers.
comment:
  v: Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/R4/resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/R4/resource.html#meta) element to indicate where the current master source of the resource can be found.
requirements:
  v: Allows the structure definition to be referenced by a single globally unique identifier.
alias:
  v: url
alias:
  v: authoritative-url
alias:
  v: destination
alias:
  v: identity
min:
  v: 1
max:
  v: 1
base:
  path:
    v: StructureDefinition.url
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.url
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier

id:
  v: StructureDefinition.identifier
path:
  v: StructureDefinition.identifier
short:
  v: Additional identifier for the structure definition
definition:
  v: A formal identifier that is used to identify this structure definition when it is represented in other formats, or referenced in a specification, model, design or an instance.
comment:
  v: Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this structure definition outside of FHIR, where it is not possible to use the logical URI.
requirements:
  v: Allows externally provided and/or usable business identifiers to be easily associated with the module.
min:
  v: 0
max:
  v: *
base:
  path:
    v: StructureDefinition.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier
mapping:
  identity:
    v: iso11179
  map:
    v: Identifier part
mapping:
  identity:
    v: objimpl
  map:
    v: no-gen-base

id:
  v: StructureDefinition.version
path:
  v: StructureDefinition.version
short:
  v: Business version of the structure definition
definition:
  v: The identifier that is used to identify this version of the structure definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the structure definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
comment:
  v: There may be different structure definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the structure definition with the format [url]|[version].
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.version
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.version
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.version
mapping:
  identity:
    v: iso11179
  map:
    v: Version

id:
  v: StructureDefinition.name
path:
  v: StructureDefinition.name
short:
  v: Name for this structure definition (computer friendly)
definition:
  v: A natural language name identifying the structure definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.
comment:
  v: The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.Some Examples: * O2SatObservation * PresentationReport * Immunization2 * AcmeAdmissionRecordOld.
requirements:
  v: Support human navigation and code generation.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: StructureDefinition.name
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: string
    l: string
condition:
  v: inv-0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: StructureDefinition.title
path:
  v: StructureDefinition.title
short:
  v: Name for this structure definition (human friendly)
definition:
  v: A short, descriptive, user-friendly title for the structure definition.
comment:
  v: This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.Applications don't have to use this name but can always fall back to it. The title also corresponds to the label for the root element.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.title
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.title

id:
  v: StructureDefinition.status
path:
  v: StructureDefinition.status
short:
  v: draft | active | retired | unknown
definition:
  v: The status of this structure definition. Enables tracking the life-cycle of the content.
comment:
  v: Allows filtering of structure definitions that are appropriate for use versus not.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: StructureDefinition.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: PublicationStatus
  strength:
    v: required
  description:
    v: The lifecycle status of an artifact.
  value set:
    v: http://hl7.org/fhir/ValueSet/publication-status|4.0.1
    l: http://hl7.org/fhir/ValueSet/publication-status
mapping:
  identity:
    v: workflow
  map:
    v: Definition.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status
mapping:
  identity:
    v: iso11179
  map:
    v: Registration status

id:
  v: StructureDefinition.experimental
path:
  v: StructureDefinition.experimental
short:
  v: For testing purposes, not real usage
definition:
  v: A Boolean value to indicate that this structure definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
comment:
  v: Allows filtering of structure definitions that are appropriate for use versus not.
requirements:
  v: Enables experimental content to be developed following the same lifecycle that would be used for a production-level structure definition.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.experimental
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.experimental
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class
mapping:
  identity:
    v: iso11179
  map:
    v: Registration status

id:
  v: StructureDefinition.date
path:
  v: StructureDefinition.date
short:
  v: Date last changed
definition:
  v: The date (and optionally time) when the structure definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the structure definition changes.
comment:
  v: Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the structure definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
alias:
  v: Revision Date
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.date
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.date
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded

id:
  v: StructureDefinition.publisher
path:
  v: StructureDefinition.publisher
short:
  v: Name of the publisher (organization or individual)
definition:
  v: The name of the organization or individual that published the structure definition.
comment:
  v: Usually an organization but may be an individual. The publisher (or steward) of the structure definition is the organization or individual primarily responsible for the maintenance and upkeep of the structure definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the structure definition. This item SHOULD be populated unless the information is available from context.
requirements:
  v: Helps establish the "authority/credibility" of the structure definition. May also allow for contact.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.publisher
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.publisher
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.witness
mapping:
  identity:
    v: iso11179
  map:
    v: Registration Authority

id:
  v: StructureDefinition.contact
path:
  v: StructureDefinition.contact
short:
  v: Contact details for the publisher
definition:
  v: Contact details to assist a user in finding and communicating with the publisher.
comment:
  v: May be a web site, an email address, a telephone number, etc.
min:
  v: 0
max:
  v: *
base:
  path:
    v: StructureDefinition.contact
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: ContactDetail
    l: ContactDetail
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.contact

id:
  v: StructureDefinition.description
path:
  v: StructureDefinition.description
short:
  v: Natural language description of the structure definition
definition:
  v: A free text natural language description of the structure definition from a consumer's perspective.
comment:
  v: This description can be used to capture details such as why the structure definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the structure definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the structure definition is presumed to be the predominant language in the place the structure definition was created).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.description
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: markdown
    l: markdown
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Definition.description

id:
  v: StructureDefinition.useContext
path:
  v: StructureDefinition.useContext
short:
  v: The context that the content is intended to support
definition:
  v: The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate structure definition instances.
comment:
  v: When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
requirements:
  v: Assist in searching for appropriate content.
min:
  v: 0
max:
  v: *
base:
  path:
    v: StructureDefinition.useContext
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: UsageContext
    l: UsageContext
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Definition.useContext

id:
  v: StructureDefinition.jurisdiction
path:
  v: StructureDefinition.jurisdiction
short:
  v: Intended jurisdiction for structure definition (if applicable)
definition:
  v: A legal or geographic region in which the structure definition is intended to be used.
comment:
  v: It may be possible for the structure definition to be used in jurisdictions other than those for which it was originally designed or intended.
min:
  v: 0
max:
  v: *
base:
  path:
    v: StructureDefinition.jurisdiction
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Jurisdiction
  strength:
    v: extensible
  description:
    v: Countries and regions within which this artifact is targeted for use.
  value set:
    v: http://hl7.org/fhir/ValueSet/jurisdiction|4.0.1
    l: http://hl7.org/fhir/ValueSet/jurisdiction
mapping:
  identity:
    v: workflow
  map:
    v: Definition.jurisdiction

id:
  v: StructureDefinition.purpose
path:
  v: StructureDefinition.purpose
short:
  v: Why this structure definition is defined
definition:
  v: Explanation of why this structure definition is needed and why it has been designed as it has.
comment:
  v: This element does not describe the usage of the structure definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this structure definition.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.purpose
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: markdown
    l: markdown
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Definition.purpose
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.why[x]
mapping:
  identity:
    v: objimpl
  map:
    v: no-gen-base

id:
  v: StructureDefinition.copyright
path:
  v: StructureDefinition.copyright
short:
  v: Use and/or publishing restrictions
definition:
  v: A copyright statement relating to the structure definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the structure definition.
requirements:
  v: Consumers must be able to determine any legal restrictions on the use of the structure definition and/or its content.
alias:
  v: License
alias:
  v: Restrictions
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.copyright
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: markdown
    l: markdown
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Definition.copyright
mapping:
  identity:
    v: objimpl
  map:
    v: no-gen-base

id:
  v: StructureDefinition.keyword
path:
  v: StructureDefinition.keyword
short:
  v: Assist with indexing and finding
definition:
  v: A set of key words or terms from external terminologies that may be used to assist with indexing and searching of templates nby describing the use of this structure definition, or the content it describes.
requirements:
  v: Assist in searching for appropriate StructureDefinitions.
min:
  v: 0
max:
  v: *
base:
  path:
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type:
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    v: Coding
    l: Coding
constraint:
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    v: ele-1
  severity:
    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
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  v: false
is summary:
  v: true
binding:
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      l: elementdefinition-bindingName
    value: String
      v: StructureDefinitionKeyword
  strength:
    v: extensible
  description:
    v: Codes for the meaning of the defined structure (SNOMED CT and LOINC codes, as an example).
  value set:
    v: http://hl7.org/fhir/ValueSet/definition-use|4.0.1
    l: http://hl7.org/fhir/ValueSet/definition-use
mapping:
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    v: iso11179
  map:
    v: keywords

id:
  v: StructureDefinition.fhirVersion
path:
  v: StructureDefinition.fhirVersion
short:
  v: FHIR Version this StructureDefinition targets
definition:
  v: The version of the FHIR specification on which this StructureDefinition is based - this is the formal version of the specification, without the revision number, e.g. [publication].[major].[minor], which is 4.0.1. for this version.
comment:
  v: A StructureDefinition does not need to specify the target it applies to as StructureDefinitions will often be valid across multiple versions of FHIR. FHIR tooling can determine whether a StructureDefinition is consistent with a particular StructureDefinition if desired.
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
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  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: FHIRVersion
  strength:
    v: required
  description:
    v: All published FHIR Versions.
  value set:
    v: http://hl7.org/fhir/ValueSet/FHIR-version|4.0.1
    l: http://hl7.org/fhir/ValueSet/FHIR-version

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  v: StructureDefinition.mapping
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  v: External specification that the content is mapped to
definition:
  v: An external specification that the content is mapped to.
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    v: error
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    v: All FHIR elements must have a @value or children
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is summary:
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id:
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path:
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  v: Unique id for inter-element referencing
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      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
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id:
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path:
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short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
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alias:
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    v: All FHIR elements must have a @value or children
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    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
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constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
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    v: extension.exists() != value.exists()
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  source:
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is modifier:
  v: false
is summary:
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mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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path:
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short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
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    v: error
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mapping:
  identity:
    v: rim
  map:
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id:
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path:
  v: StructureDefinition.mapping.identity
short:
  v: Internal id when this mapping is used
definition:
  v: An Internal id that is used to identify this mapping set when specific mappings are made.
comment:
  v: The specification is described once, with general comments, and then specific mappings are made that reference this declaration.
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    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: StructureDefinition.mapping.uri
path:
  v: StructureDefinition.mapping.uri
short:
  v: Identifies what this mapping refers to
definition:
  v: An absolute URI that identifies the specification that this mapping is expressed to.
comment:
  v: A formal identity for the specification being mapped to helps with identifying maps consistently.
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    v: error
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    v: All FHIR elements must have a @value or children
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id:
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  v: Names what this mapping refers to
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  v: A name for the specification that is being mapped to.
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id:
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path:
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id:
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    v: Defines the type of structure that a definition is describing.
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    l: http://hl7.org/fhir/ValueSet/structure-definition-kind

id:
  v: StructureDefinition.abstract
path:
  v: StructureDefinition.abstract
short:
  v: Whether the structure is abstract
definition:
  v: Whether structure this definition describes is abstract or not - that is, whether the structure is not intended to be instantiated. For Resources and Data types, abstract types will never be exchanged between systems.
comment:
  v: Abstract Resources cannot be instantiated - a concrete sub-type must be used. Abstract datatypes and extensions cannot be used in an instance. For logical models, the exact implication of "abstract" will rest with the author, depending how the logical model is used. Flagging a constraint structure as abstract conveys design intent but makes no difference to how the structure definition is handled. Note that inline declared elements that are given the type "Element" in the StructureDefinition, but have children described, are anonymous concrete types that specialize Element.
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id:
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path:
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id:
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path:
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      v: string
      l: string
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  map:
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id:
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path:
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short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: 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.
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  map:
    v: n/a

id:
  v: StructureDefinition.context.modifierExtension
path:
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short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
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alias:
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    v: All FHIR elements must have a @value or children
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mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: StructureDefinition.context.type
path:
  v: StructureDefinition.context.type
short:
  v: fhirpath | element | extension
definition:
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    v: All FHIR elements must have a @value or children
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  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ExtensionContextType
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  description:
    v: How an extension context is interpreted.
  value set:
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    l: http://hl7.org/fhir/ValueSet/extension-context-type

id:
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path:
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short:
  v: Where the extension can be used in instances
definition:
  v: An expression that defines where an extension can be used in resources.
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
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  source:
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    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: StructureDefinition.contextInvariant
path:
  v: StructureDefinition.contextInvariant
short:
  v: FHIRPath invariants - when the extension can be used
definition:
  v: A set of rules as FHIRPath Invariants about when the extension can be used (e.g. co-occurrence variants for the extension). All the rules must be true.
comment:
  v: The rules are only evaluated when the extension is present. When evaluating the invariant, the FHIRPath focus is the element that holds the extension, and %extension refers to the extension itself.
min:
  v: 0
max:
  v: *
base:
  path:
    v: StructureDefinition.contextInvariant
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: string
    l: string
condition:
  v: sdf-18
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: StructureDefinition.type
path:
  v: StructureDefinition.type
short:
  v: Type defined or constrained by this structure
definition:
  v: The type this structure describes. If the derivation kind is 'specialization' then this is the master definition for a type, and there is always one of these (a data type, an extension, a resource, including abstract ones). Otherwise the structure definition is a constraint on the stated type (and in this case, the type cannot be an abstract type). References are URLs that are relative to http://hl7.org/fhir/StructureDefinition e.g. "string" is a reference to http://hl7.org/fhir/StructureDefinition/string. Absolute URLs are only allowed in logical models.
comment:
  v: Note that in the case of constraints, the type could be determined by chasing through the baseDefinition references until a concrete structure (derivation = specialization) is reached, or by looking at the path of the first element in the snapshot - if present - but providing the type directly makes for simpler tooling and indexing. The type must match the elements defined in the differential and the snapshot. For all FHIR defined types, the path name of the element will start with the type name. For logical models, where the type is a URL, the type name SHOULD start with the tail of the type URL where required.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: StructureDefinition.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
condition:
  v: sdf-11
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: FHIRDefinedTypeExt
  strength:
    v: extensible
  description:
    v: Either a resource or a data type, including logical model types.
  value set:
    v: http://hl7.org/fhir/ValueSet/defined-types|4.0.1
    l: http://hl7.org/fhir/ValueSet/defined-types

id:
  v: StructureDefinition.baseDefinition
path:
  v: StructureDefinition.baseDefinition
short:
  v: Definition that this type is constrained/specialized from
definition:
  v: An absolute URI that is the base structure from which this type is derived, either by specialization or constraint.
comment:
  v: If differential constraints are specified in this structure, they are applied to the base in a "differential" fashion. If there is no base, then the differential constraints cannot be provided (snapshot only). Differential structures are useful for the editing perspective, and snapshot structures are suitable for operational use. The FHIR Project provides a number of tools/services to populate snapshots from differential constraints. Logical Models have a base of "Element" or another logical model.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.baseDefinition
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy
      l: structuredefinition-hierarchy
    value: Boolean
      v: true
  code:
    v: canonical
    l: canonical
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/StructureDefinition
condition:
  v: sdf-4
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: StructureDefinition.derivation
path:
  v: StructureDefinition.derivation
short:
  v: specialization | constraint - How relates to base definition
definition:
  v: How the type relates to the baseDefinition.
comment:
  v: If the definition is a specialization, then it adds new elements in the differential, and the snapshot includes the inherited elements. If the definition is a constraint, then it cannot define new elements, it can only make new rules about existing content (see [Profiling Resources](http://hl7.org/fhir/R4/profiling.html#resources)).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.derivation
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: TypeDerivationRule
  strength:
    v: required
  description:
    v: How a type relates to its baseDefinition.
  value set:
    v: http://hl7.org/fhir/ValueSet/type-derivation-rule|4.0.1
    l: http://hl7.org/fhir/ValueSet/type-derivation-rule

id:
  v: StructureDefinition.snapshot
path:
  v: StructureDefinition.snapshot
short:
  v: Snapshot view of the structure
definition:
  v: A snapshot view is expressed in a standalone form that can be used and interpreted without considering the base StructureDefinition.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.snapshot
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement
condition:
  v: sdf-6
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: sdf-3
  severity:
    v: error
  human:
    v: Each element definition in a snapshot must have a formal definition and cardinalities
  expression:
    v: element.all(definition.exists() and min.exists() and max.exists())
  xpath:
    v: count(f:element) = count(f:element[exists(f:definition) and exists(f:min) and exists(f:max)])
  source:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    l: StructureDefinition
constraint:
  key:
    v: sdf-8
  severity:
    v: error
  human:
    v: All snapshot elements must start with the StructureDefinition's specified type for non-logical models, or with the same type name for logical models
  expression:
    v: (%resource.kind = 'logical' or element.first().path = %resource.type) and element.tail().all(path.startsWith(%resource.snapshot.element.first().path&'.'))
  xpath:
    v: f:element[1]/f:path/@value=parent::f:StructureDefinition/f:type/@value and count(f:element[position()!=1])=count(f:element[position()!=1][starts-with(f:path/@value, concat(ancestor::f:StructureDefinition/f:type/@value, '.'))])
  source:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    l: StructureDefinition
constraint:
  key:
    v: sdf-8b
  severity:
    v: error
  human:
    v: All snapshot elements must have a base definition
  expression:
    v: element.all(base.exists())
  xpath:
    v: count(f:element) = count(f:element/f:base)
  source:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    l: StructureDefinition
is modifier:
  v: false
is summary:
  v: false

id:
  v: StructureDefinition.snapshot.id
path:
  v: StructureDefinition.snapshot.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: StructureDefinition.snapshot.extension
path:
  v: StructureDefinition.snapshot.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: StructureDefinition.snapshot.modifierExtension
path:
  v: StructureDefinition.snapshot.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: StructureDefinition.snapshot.element
path:
  v: StructureDefinition.snapshot.element
short:
  v: Definition of elements in the resource (if no StructureDefinition)
definition:
  v: Captures constraints on each element within the resource.
min:
  v: 1
max:
  v: *
base:
  path:
    v: StructureDefinition.snapshot.element
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: ElementDefinition
    l: ElementDefinition
condition:
  v: sdf-3
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: sdf-10
  requirements:
    v: binding is required
  severity:
    v: error
  human:
    v: provide either a binding reference or a description (or both)
  expression:
    v: binding.empty() or binding.valueSet.exists() or binding.description.exists()
  xpath:
    v: not(exists(f:binding)) or exists(f:binding/f:valueSet) or exists(f:binding/f:description)
  source:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    l: StructureDefinition
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: iso11179
  map:
    v: --

id:
  v: StructureDefinition.differential
path:
  v: StructureDefinition.differential
short:
  v: Differential view of the structure
definition:
  v: A differential view is expressed relative to the base StructureDefinition - a statement of differences that it applies.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: StructureDefinition.differential
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement
condition:
  v: sdf-6
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: sdf-20
  requirements:
    v: no slicing on root
  severity:
    v: error
  human:
    v: No slicing on the root element
  expression:
    v: element.where(path.contains('.').not()).slicing.empty()
  xpath:
    v: not(f:element[1]/f:slicing)
  source:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    l: StructureDefinition
constraint:
  key:
    v: sdf-8a
  severity:
    v: error
  human:
    v: In any differential, all the elements must start with the StructureDefinition's specified type for non-logical models, or with the same type name for logical models
  expression:
    v: (%resource.kind = 'logical' or element.first().path.startsWith(%resource.type)) and (element.tail().empty() or element.tail().all(path.startsWith(%resource.differential.element.first().path.replaceMatches('\\..*','')&'.')))
  xpath:
    v: count(f:element)=count(f:element[f:path/@value=ancestor::f:StructureDefinition/f:type/@value or starts-with(f:path/@value, concat(ancestor::f:StructureDefinition/f:type/@value, '.'))])
  source:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    l: StructureDefinition
is modifier:
  v: false
is summary:
  v: false

id:
  v: StructureDefinition.differential.id
path:
  v: StructureDefinition.differential.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: StructureDefinition.differential.extension
path:
  v: StructureDefinition.differential.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: StructureDefinition.differential.modifierExtension
path:
  v: StructureDefinition.differential.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: StructureDefinition.differential.element
path:
  v: StructureDefinition.differential.element
short:
  v: Definition of elements in the resource (if no StructureDefinition)
definition:
  v: Captures constraints on each element within the resource.
min:
  v: 1
max:
  v: *
base:
  path:
    v: StructureDefinition.differential.element
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: ElementDefinition
    l: ElementDefinition
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: iso11179
  map:
    v: --

element:
  id:
    v: StructureDefinition
  path:
    v: StructureDefinition