Clinical Document Architecture with Australian Schema, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/cda-au-schema/ and changes regularly. See the Directory of published versions

Logical Model: Reference - XML Profile

Active as of 2024-11-22

XML representation of the Reference logical model.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Reference"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>CDA entries can reference external objects such as external images and prior reports. These external objects are not part of the authenticated document content. They contain sufficient attributes to enable an explicit reference rather than duplicating the entire referenced object. The CDA entry that wraps the external reference can be used to encode the specific portions of the external reference that are addressed in the narrative block.</p>
      <p>Each object allows for an identifier and a code, and contains the RIM Act.text attribute, which can be used to store the URL and MIME type of the object. External objects always have a fixed moodCode of &quot;EVN&quot;.</p>
      <p>The reference class contains the attribute reference.seperatableInd, which indicates whether or not the source is intended to be interpreted independently of the target. The indicator cannot prevent an individual or application from separating the source and target, but indicates the author's desire and willingness to attest to the content of the source if separated from the target. Typically, where seperatableInd is &quot;false&quot;, the exchanged package should include the target of the reference so that the recipient can render it.</p>
    </div>
  </text>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/logical-target">
    <valueBoolean>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
        <valueCode value="not-applicable"/>
      </extension>
    </valueBoolean>
  </extension>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/xml-namespace">
    <valueUri value="urn:hl7-org:v3"/>
  </extension>
  <extension url="http://hl7.org/fhir/tools/StructureDefinition/xml-name">
    <valueString value="reference"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/logical-container">
    <valueUri
              value="http://hl7.org/cda/stds/core/StructureDefinition/ClinicalDocument"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/type-profile-style">
    <valueUri value="cda"/>
  </extension>
  <url value="http://hl7.org/cda/stds/core/StructureDefinition/Reference"/>
  <version value="1.0.0"/>
  <name value="Reference"/>
  <title value="Reference (CDA Class)"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-11-22T03:02:41+00:00"/>
  <publisher value="HL7"/>
  <description
               value="CDA entries can reference external objects such as external images and prior reports. These external objects are not part of the authenticated document content. They contain sufficient attributes to enable an explicit reference rather than duplicating the entire referenced object. The CDA entry that wraps the external reference can be used to encode the specific portions of the external reference that are addressed in the narrative block.

Each object allows for an identifier and a code, and contains the RIM Act.text attribute, which can be used to store the URL and MIME type of the object. External objects always have a fixed moodCode of &quot;EVN&quot;.

The reference class contains the attribute reference.seperatableInd, which indicates whether or not the source is intended to be interpreted independently of the target. The indicator cannot prevent an individual or application from separating the source and target, but indicates the author's desire and willingness to attest to the content of the source if separated from the target. Typically, where seperatableInd is &quot;false&quot;, the exchanged package should include the target of the reference so that the recipient can render it."/>
  <fhirVersion value="5.0.0"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <kind value="logical"/>
  <abstract value="false"/>
  <type value="http://hl7.org/cda/stds/core/StructureDefinition/Reference"/>
  <baseDefinition
                  value="http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="Reference">
      <path value="Reference"/>
      <short value="Base for all types and resources"/>
      <definition
                  value="Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Base"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="reference-external"/>
        <severity value="error"/>
        <human value="Must contain one (and only one) external reference"/>
        <expression
                    value="(externalAct | externalObservation | externalProcedure | externalDocument).count() = 1"/>
      </constraint>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Reference.nullFlavor">
      <path value="Reference.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Reference.realmCode">
      <path value="Reference.realmCode"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="InfrastructureRoot.realmCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CS"/>
      </type>
    </element>
    <element id="Reference.typeId">
      <path value="Reference.typeId"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="InfrastructureRoot.typeId"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Reference.typeId.nullFlavor">
      <path value="Reference.typeId.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Reference.typeId.assigningAuthorityName">
      <path value="Reference.typeId.assigningAuthorityName"/>
      <representation value="xmlAttr"/>
      <label value="Assigning Authority Name"/>
      <definition
                  value="A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="II.assigningAuthorityName"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Reference.typeId.displayable">
      <path value="Reference.typeId.displayable"/>
      <representation value="xmlAttr"/>
      <label value="Displayable"/>
      <definition
                  value="Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="II.displayable"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"/>
      </type>
    </element>
    <element id="Reference.typeId.root">
      <path value="Reference.typeId.root"/>
      <representation value="xmlAttr"/>
      <label value="Root"/>
      <definition value="Identifies the type as an HL7 Registered model"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="II.root"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/oid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/uuid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/ruid"/>
      </type>
      <fixedString value="2.16.840.1.113883.1.3"/>
    </element>
    <element id="Reference.typeId.extension">
      <path value="Reference.typeId.extension"/>
      <representation value="xmlAttr"/>
      <label value="Extension"/>
      <definition
                  value="A character string as a unique identifier within the scope of the identifier root."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="II.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Reference.templateId">
      <path value="Reference.templateId"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="InfrastructureRoot.templateId"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Reference.typeCode">
      <path value="Reference.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.typeCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference"/>
      </binding>
    </element>
    <element id="Reference.seperatableInd">
      <path value="Reference.seperatableInd"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.seperatableInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/BL"/>
      </type>
    </element>
    <element id="Reference.externalAct">
      <path value="Reference.externalAct"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.externalAct"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct"/>
      </type>
    </element>
    <element id="Reference.externalObservation">
      <path value="Reference.externalObservation"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.externalObservation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation"/>
      </type>
    </element>
    <element id="Reference.externalProcedure">
      <path value="Reference.externalProcedure"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.externalProcedure"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure"/>
      </type>
    </element>
    <element id="Reference.externalDocument">
      <path value="Reference.externalDocument"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.externalDocument"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument"/>
      </type>
    </element>
  </snapshot>
  <differential>
    <element id="Reference">
      <path value="Reference"/>
      <min value="1"/>
      <max value="*"/>
      <constraint>
        <key value="reference-external"/>
        <severity value="error"/>
        <human value="Must contain one (and only one) external reference"/>
        <expression
                    value="(externalAct | externalObservation | externalProcedure | externalDocument).count() = 1"/>
      </constraint>
    </element>
    <element id="Reference.typeCode">
      <path value="Reference.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference"/>
      </binding>
    </element>
    <element id="Reference.seperatableInd">
      <path value="Reference.seperatableInd"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/BL"/>
      </type>
    </element>
    <element id="Reference.externalAct">
      <path value="Reference.externalAct"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct"/>
      </type>
    </element>
    <element id="Reference.externalObservation">
      <path value="Reference.externalObservation"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation"/>
      </type>
    </element>
    <element id="Reference.externalProcedure">
      <path value="Reference.externalProcedure"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure"/>
      </type>
    </element>
    <element id="Reference.externalDocument">
      <path value="Reference.externalDocument"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument"/>
      </type>
    </element>
  </differential>
</StructureDefinition>