<?xml version="1.0" encoding="UTF-8"?>
<!-- 
 * #%L
 * org.hl7.fhir.r5
 * %%
 * Copyright (C) 2014 - 2019 Health Level 7
 * %%
 * Licensed under the Apache License, Version 2.0 (the "License");
 * you may not use this file except in compliance with the License.
 * You may obtain a copy of the License at
 * 
 *      http://www.apache.org/licenses/LICENSE-2.0
 * 
 * Unless required by applicable law or agreed to in writing, software
 * distributed under the License is distributed on an "AS IS" BASIS,
 * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
 * See the License for the specific language governing permissions and
 * limitations under the License.
 * #L%
 */

/*
  Copyright (c) 2011+, HL7, Inc.
  All rights reserved.
  
  Redistribution and use in source and binary forms, with or without modification, 
  are permitted provided that the following conditions are met:
  
   * Redistributions of source code must retain the above copyright notice, this 
     list of conditions and the following disclaimer.
   * Redistributions in binary form must reproduce the above copyright notice, 
     this list of conditions and the following disclaimer in the documentation 
     and/or other materials provided with the distribution.
   * Neither the name of HL7 nor the names of its contributors may be used to 
     endorse or promote products derived from this software without specific 
     prior written permission.
  
  THIS SOFTWARE IS PROVIDED BY THE COPYRIGHT HOLDERS AND CONTRIBUTORS "AS IS" AND 
  ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED 
  WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE ARE DISCLAIMED. 
  IN NO EVENT SHALL THE COPYRIGHT HOLDER OR CONTRIBUTORS BE LIABLE FOR ANY DIRECT, 
  INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT 
  NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATA, OR 
  PROFITS; OR BUSINESS INTERRUPTION) HOWEVER CAUSED AND ON ANY THEORY OF LIABILITY, 
  WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) 
  ARISING IN ANY WAY OUT OF THE USE OF THIS SOFTWARE, EVEN IF ADVISED OF THE 
  POSSIBILITY OF SUCH DAMAGE.
  

  Generated on Tue, May 19, 2026 20:26+0000 for FHIR v6.0.0-ballot4 

  Note: the schemas &amp; schematrons do not contain all of the rules about what makes resources
  valid. Implementers will still need to be familiar with the content of the specification and with
  any profiles that apply to the resources in order to make a conformant implementation.

-->
<xs:schema xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns="http://hl7.org/fhir" xmlns:xhtml="http://www.w3.org/1999/xhtml" targetNamespace="http://hl7.org/fhir" elementFormDefault="qualified" version="1.0">
  <xs:include schemaLocation="fhir-base.xsd"/>
  <xs:element name="DocumentReference" type="DocumentReference">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
    </xs:annotation>
  </xs:element>
  <xs:complexType name="DocumentReference">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
      <xs:documentation xml:lang="en">If the element is present, it must have either a @value, an @id, or extensions</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="DomainResource">
        <xs:sequence>
          <xs:element name="identifier" minOccurs="0" maxOccurs="unbounded" type="Identifier">
            <xs:annotation>
              <xs:documentation xml:lang="en">Business identifiers assigned to this document reference by the performer and/or other systems.  These identifiers remain constant as the resource is updated and propagates from server to server.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="version" minOccurs="0" maxOccurs="1" type="string">
            <xs:annotation>
              <xs:documentation xml:lang="en">An explicitly assigned identifier of a variation of the content in the DocumentReference.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="basedOn" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">An activity that is fulfilled in whole or in part by the creation of this document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="status" minOccurs="1" maxOccurs="1" type="DocumentReferenceStatus">
            <xs:annotation>
              <xs:documentation xml:lang="en">The current state of the document reference.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="docStatus" minOccurs="0" maxOccurs="1" type="CompositionStatus">
            <xs:annotation>
              <xs:documentation xml:lang="en">The status of the underlying document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="modality" minOccurs="0" maxOccurs="unbounded" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">Imaging modality used. This may include both acquisition and non-acquisition modalities.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="type" minOccurs="0" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">Specifies the particular kind of document referenced  (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="category" minOccurs="0" maxOccurs="unbounded" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="subject" minOccurs="0" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">Who or what the document is about. The document can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure).</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="context" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The encounter or other triggering event during which this DocumentReference was created or to which the creation of this record is tightly associated.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="event" minOccurs="0" maxOccurs="unbounded" type="CodeableReference">
            <xs:annotation>
              <xs:documentation xml:lang="en">This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the type Code, such as a &quot;History and Physical Report&quot; in which the procedure being documented is necessarily a &quot;History and Physical&quot; act.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="related" type="DocumentReference.Related" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">Any resource to which the creation of this record is tightly associated not involving document reference lifecycle.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="bodyStructure" minOccurs="0" maxOccurs="unbounded" type="CodeableReference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The anatomic structures included in the document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="facilityType" minOccurs="0" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">The kind of facility where the patient was seen.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="practiceSetting" minOccurs="0" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="period" minOccurs="0" maxOccurs="1" type="Period">
            <xs:annotation>
              <xs:documentation xml:lang="en">The time period over which the service that is described by the document was provided.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="date" minOccurs="0" maxOccurs="1" type="dateTime">
            <xs:annotation>
              <xs:documentation xml:lang="en">When the document reference was created.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="author" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">Identifies who is responsible for adding the information to the document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="attester" type="DocumentReference.Attester" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">A participant who has authenticated the accuracy of the document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="custodian" minOccurs="0" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">Identifies the organization who is responsible for ongoing maintenance of and access to the document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="relatesTo" type="DocumentReference.RelatesTo" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">Relationships that this document reference has with other document references that already exist.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="description" minOccurs="0" maxOccurs="1" type="markdown">
            <xs:annotation>
              <xs:documentation xml:lang="en">Human-readable description of the source document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="securityLabel" minOccurs="0" maxOccurs="unbounded" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">A set of Security-Tag codes specifying the level of privacy/security of the Document found at DocumentReference.content.attachment.url. Note that DocumentReference.meta.security contains the security labels of the data elements in DocumentReference, while DocumentReference.securityLabel contains the security labels for the document the reference refers to. The distinction recognizes that the document may contain sensitive information, while the DocumentReference is metadata about the document and thus might not be as sensitive as the document. For example: a psychotherapy episode may contain highly sensitive information, while the metadata may simply indicate that some episode happened.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="content" type="DocumentReference.Content" minOccurs="1" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">The document and format referenced.  If there are multiple content element repetitions, these must all represent the same document in different format, or attachment metadata.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="DocumentReference.Related">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="code" minOccurs="0" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">Type of the relationship between the document reference and the related resource.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="target" minOccurs="1" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The target document of the related resource.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="DocumentReference.Attester">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="mode" minOccurs="1" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">The type of attestation the authenticator offers.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="time" minOccurs="0" maxOccurs="1" type="dateTime">
            <xs:annotation>
              <xs:documentation xml:lang="en">When the document was attested by the party.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="party" minOccurs="0" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">Who attested the document in the specified way.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="DocumentReference.RelatesTo">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="code" minOccurs="1" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">The type of relationship that this document has with anther document.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="target" minOccurs="1" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The target document of this relationship.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="DocumentReference.Content">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="attachment" minOccurs="1" maxOccurs="1" type="Attachment">
            <xs:annotation>
              <xs:documentation xml:lang="en">The document or URL of the document along with critical metadata to prove content has integrity.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="profile" type="DocumentReference.Profile" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">An identifier of the document constraints, encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="DocumentReference.Profile">
    <xs:annotation>
      <xs:documentation xml:lang="en">A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:choice minOccurs="1" maxOccurs="1" >
            <xs:annotation>
              <xs:documentation xml:lang="en">Code|uri|canonical.</xs:documentation>
            </xs:annotation>
            <xs:element name="valueCoding" type="Coding"/>
            <xs:element name="valueUri" type="uri"/>
            <xs:element name="valueCanonical" type="canonical"/>
          </xs:choice>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
</xs:schema>
