{
  "resourceType": "StructureDefinition",
  "id": "ncdhc-composition-antenatal-visit",
  "url": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-composition-antenatal-visit",
  "version": "dv0.0.1",
  "name": "NCDHCAntenatalVisitCompositionProfile",
  "title": "NCDHC Antenatal Visit Composition",
  "status": "draft",
  "date": "2020-01-10",
  "publisher": "National Children's Digital Health Collaborative (NCDHC)",
  "copyright": "Copyright © 2019 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/.",
  "fhirVersion": "3.0.2",
  "kind": "resource",
  "abstract": false,
  "type": "Composition",
  "baseDefinition": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-composition-base",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Composition",
        "path": "Composition",
        "short": "NCDHC Antenatal Visit Composition Profile",
        "constraint": [
          {
            "key": "inv-cmp-bp-001",
            "requirements": "Either of Vital-Sign Blood Pressure or Blood Pressure SHALL be provided but not both",
            "severity": "error",
            "human": "Either of Vital-Sign Blood Pressure or Blood Pressure SHALL be provided but not both",
            "expression": "1=1"
          },
          {
            "key": "inv-cmp-bw-002",
            "requirements": "Either of Vital-Sign Body-Weight or Body Weight SHALL be provided but not both",
            "severity": "error",
            "human": "Either of Vital-Sign Body-Weight or Body Weight SHALL be provided but not both",
            "expression": "1=1"
          }
        ]
      },
      {
        "id": "Composition.type.coding.system",
        "path": "Composition.type.coding.system",
        "fixedUri": "http://hl7.org.au/fhir/ch/v1/CodeSystem/ncdhc-hi-type-1"
      },
      {
        "id": "Composition.type.coding.code",
        "path": "Composition.type.coding.code",
        "fixedCode": "ANTVSTCLC"
      },
      {
        "id": "Composition.class.coding.system",
        "path": "Composition.class.coding.system",
        "fixedUri": "http://hl7.org.au/fhir/ch/v1/CodeSystem/ncdhc-document-class-1"
      },
      {
        "id": "Composition.class.coding.code",
        "path": "Composition.class.coding.code",
        "fixedCode": "PREGDTCLC"
      },
      {
        "id": "Composition.subject",
        "path": "Composition.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-patient-expectant-mother"
          }
        ]
      },
      {
        "id": "Composition.encounter",
        "path": "Composition.encounter",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-dphr-encounter",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.attester.party",
        "path": "Composition.attester.party",
        "short": "An organisation/practitioner who has attested to the accuracy of the composition/document.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-patient-expectant-mother",
            "aggregation": [
              "bundled"
            ]
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/StructureDefinition/au-practitioner",
            "aggregation": [
              "bundled"
            ]
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/StructureDefinition/au-organisation",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Section"
          }
        ],
        "path": "Composition.section",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "code"
            }
          ],
          "rules": "closed"
        },
        "comment": "BR06: The antenatal visit record must at least contain Maternal Health Check HI - Weeks / Gestation data element. And at least one section from the following three maternal health check, fetal health check or Progress Notes must be included in its entirety.  The attachment DPHR-58-BR-07 to provides further guidance on requirements for Encounter, Patient and document sections.",
        "min": 1
      },
      {
        "id": "Composition.section:maternal-health-checks",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Section"
          }
        ],
        "path": "Composition.section",
        "sliceName": "maternal-health-checks",
        "short": "Maternal Health Checks",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Composition.section:maternal-health-checks.title",
        "path": "Composition.section.title",
        "fixedString": "Maternal Health Checks",
        "mustSupport": true
      },
      {
        "id": "Composition.section:maternal-health-checks.code",
        "path": "Composition.section.code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "18114009"
            }
          ]
        }
      },
      {
        "id": "Composition.section:maternal-health-checks.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:maternal-health-checks.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "$this.resolve()"
            }
          ],
          "rules": "closed"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:vitalsign-bp",
        "path": "Composition.section.entry",
        "sliceName": "vitalsign-bp",
        "short": "Blood Pressure (Vital Sign - BP)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-vitalsign-bp",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:bp",
        "path": "Composition.section.entry",
        "sliceName": "bp",
        "short": "Blood Pressure (BP)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-bp",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:vitalsign-bodyweight",
        "path": "Composition.section.entry",
        "sliceName": "vitalsign-bodyweight",
        "short": "Weight Vital Sign (Kg)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-vitalsign-bodyweight",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:bodyweight",
        "path": "Composition.section.entry",
        "sliceName": "bodyweight",
        "short": "Weight (Kg)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-bodyweight",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:gestation-age",
        "path": "Composition.section.entry",
        "sliceName": "gestation-age",
        "short": "Weeks / Gestation (weeks/days)",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-estimated-gestation",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:urinalysis-protein",
        "path": "Composition.section.entry",
        "sliceName": "urinalysis-protein",
        "short": "Urinalysis",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-urinalysis-protein",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:breastfeeding-intention",
        "path": "Composition.section.entry",
        "sliceName": "breastfeeding-intention",
        "short": "Breastfeeding education",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-breastfeeding-education",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:briefIntervention-smoking",
        "path": "Composition.section.entry",
        "sliceName": "briefIntervention-smoking",
        "short": "Brief Smoking intervention",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-bi-tobacco-usage",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:briefIntervention-alcohol",
        "path": "Composition.section.entry",
        "sliceName": "briefIntervention-alcohol",
        "short": "Brief Alcohol intervention",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-bi-alcohol-intake",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:briefIntervention-other",
        "path": "Composition.section.entry",
        "sliceName": "briefIntervention-other",
        "short": "Other Brief Interventions",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-bi-other",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:illicit-drugs-gestation",
        "path": "Composition.section.entry",
        "sliceName": "illicit-drugs-gestation",
        "short": "Illicit drugs - Gestation",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-illicit-drugs-gestation",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:medication-prescriptions-changes",
        "path": "Composition.section.entry",
        "sliceName": "medication-prescriptions-changes",
        "short": "Medication / Prescriptions changes",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-medication-pres-change",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.entry:emotional-health-and-wellbeing",
        "path": "Composition.section.entry",
        "sliceName": "emotional-health-and-wellbeing",
        "short": "Emotional Health and Wellbeing",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-emotional-health-and-wellbeing",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:maternal-health-checks.section",
        "path": "Composition.section.section",
        "max": "0"
      },
      {
        "id": "Composition.section:fetal-health-check",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Section"
          }
        ],
        "path": "Composition.section",
        "sliceName": "fetal-health-check",
        "short": "Fetal Health Checks",
        "min": 1
      },
      {
        "id": "Composition.section:fetal-health-check.title",
        "path": "Composition.section.title",
        "fixedString": "Fetal Health Checks",
        "mustSupport": true
      },
      {
        "id": "Composition.section:fetal-health-check.code",
        "path": "Composition.section.code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "713117007"
            }
          ]
        }
      },
      {
        "id": "Composition.section:fetal-health-check.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:fetal-health-check.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "closed"
        }
      },
      {
        "id": "Composition.section:fetal-health-check.entry:fetal-heart-rate",
        "path": "Composition.section.entry",
        "sliceName": "fetal-heart-rate",
        "short": "Fetal Heart Rate (FHR)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-vitalsign-heart-rate"
          }
        ]
      },
      {
        "id": "Composition.section:fetal-health-check.entry:fetal-movements",
        "path": "Composition.section.entry",
        "sliceName": "fetal-movements",
        "short": "Fetal Movements (FM)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-fetal-movement",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:fetal-health-check.entry:arrangement-of-fetus",
        "path": "Composition.section.entry",
        "sliceName": "arrangement-of-fetus",
        "short": "The presentation, position or lie of the fetus",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-fetus-arrangement",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:fetal-health-check.entry:symphyseal-fundal-height",
        "path": "Composition.section.entry",
        "sliceName": "symphyseal-fundal-height",
        "short": "Symphyseal-fundal height (SFH)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-symphyseal-fundal-height",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:fetal-health-check.entry:head-engagement",
        "path": "Composition.section.entry",
        "sliceName": "head-engagement",
        "short": "Descent \\ Engagement \\ Station (Fifths above brim)",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-head-engagement",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:fetal-health-check.entry:liquor",
        "path": "Composition.section.entry",
        "sliceName": "liquor",
        "short": "Liquor",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-observation-fetus-liquor",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:fetal-health-check.section",
        "path": "Composition.section.section",
        "max": "0"
      },
      {
        "id": "Composition.section:progress-notes",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Section"
          }
        ],
        "path": "Composition.section",
        "sliceName": "progress-notes",
        "short": "Progress notes / Comments",
        "comment": "Refer to the https://build.fhir.org/ig/HL7/US-Core-R4/clinical-notes-guidance.html for more details.\r\n\r\n\"All of these clinical notes SHALL be exposed via DocumentReference. This requirement is necessary because some systems scan lab reports and don’t store them in the DiagnosticReport resource. See FHIR Resources to Exchange Clinical Notes for more detail.\"\r\n\r\nIn NCDHC, we are using Encounter instance (the same encoutner instance as referred from the Composition in context) referenced from the DocumentReference to record the following details:\r\n1. Registered interpreter present during the examination\r\n2. Next Visit Date and Time",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Composition.section:progress-notes.title",
        "path": "Composition.section.title",
        "fixedString": "Progress notes",
        "mustSupport": true
      },
      {
        "id": "Composition.section:progress-notes.code",
        "path": "Composition.section.code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "371530004"
            }
          ]
        }
      },
      {
        "id": "Composition.section:progress-notes.text",
        "path": "Composition.section.text",
        "short": "Progress notes / Comments goes here",
        "comment": "Notes and comments on the progress of the pregnancy",
        "mustSupport": true
      },
      {
        "id": "Composition.section:progress-notes.entry",
        "path": "Composition.section.entry",
        "short": "Progress notes / Comments. If the section is present, then an entry must be present",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-documentreference-clinical-notes",
            "aggregation": [
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:progress-notes.section",
        "path": "Composition.section.section",
        "max": "0"
      }
    ]
  }
}