Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

Resource Profile: ADHABodyStructureCore - Detailed Descriptions

Active as of 2024-12-19

Definitions for the dh-bodystructure-core-1 resource profile.

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

0. BodyStructure
ShortAnatomical location
Invariantsinv-dh-bodstr-01: The body structure shall at least have a location or a description (location.exists() or description.exists())
2. BodyStructure.active
Fixed Valuetrue
4. BodyStructure.morphology
Must Supporttrue
6. BodyStructure.location
BindingUnless not suitable, these codes SHALL be taken from Body Site .
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
Must Supporttrue
Invariantsinv-dh-bodstr-02: If a coded body site is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
8. BodyStructure.locationQualifier
BindingUnless not suitable, these codes SHALL be taken from Body Site Relative Site Qualifier .
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-relative-site-qualifier-1)
Must Supporttrue
Invariantsinv-dh-bodstr-03: If a coded location qualifier is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
10. BodyStructure.description
Must Supporttrue
12. BodyStructure.patient
TypeReference(ADHA Core Patient)
Must Supporttrue
Invariantsinv-dh-bodstr-04: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())

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

0. BodyStructure
Definition

Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

ShortAnatomical locationSpecific and identified anatomical structure
Control0..*
Is Modifierfalse
Summaryfalse
Alternate Namesanatomical location
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
inv-bodstr-0: The body structure shall at least have location or description or an image (location.exists() or description.exists() or image.exists())
inv-dh-bodstr-01: The body structure shall at least have a location or a description (location.exists() or description.exists())
2. BodyStructure.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. BodyStructure.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. BodyStructure.active
Definition

Whether this body site is in active use.

ShortWhether this record is in active use
Comments

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

Control0..1
Typeboolean
Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to be able to mark a body site entry as not to be used because it was created in error.

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
Fixed Valuetrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. BodyStructure.morphology
Definition

The kind of structure being represented by the body structure at BodyStructure.location. This can define both normal and abnormal morphologies.

ShortKind of Structure
Comments

The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology.

Control0..1
BindingThe codes SHOULD be taken from For example codes, see SNOMEDCTMorphologicAbnormalitieshttp://hl7.org/fhir/ValueSet/bodystructure-code
(preferred to http://hl7.org/fhir/ValueSet/bodystructure-code)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. BodyStructure.location
Definition

The anatomical location or region of the specimen, lesion, or body structure.

ShortBody site
Control0..1
This element is affected by the following invariants: inv-bodstr-0, inv-dh-bodstr-02
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Body Site .http://hl7.org/fhir/ValueSet/body-site
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-bodstr-02: If a coded body site is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
12. BodyStructure.locationQualifier
Definition

Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

ShortBody site modifier
Control0..*
This element is affected by the following invariants: inv-dh-bodstr-03
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Body Site Relative Site Qualifier .http://hl7.org/fhir/ValueSet/bodystructure-relative-location
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-relative-site-qualifier-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-bodstr-03: If a coded location qualifier is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
14. BodyStructure.description
Definition

A summary, characterization or explanation of the body structure.

ShortText description
Comments

This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.

Control0..1
This element is affected by the following invariants: inv-bodstr-0, inv-dh-bodstr-01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. BodyStructure.patient
Definition

The person to which the body site belongs.

ShortWho this is about
Control1..1
This element is affected by the following invariants: inv-dh-bodstr-04
TypeReference(ADHA Core Patient, Patient)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-bodstr-04: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())

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

0. BodyStructure
Definition

Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

ShortAnatomical location
Control0..*
Is Modifierfalse
Summaryfalse
Alternate Namesanatomical location
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
inv-bodstr-0: The body structure shall at least have location or description or an image (location.exists() or description.exists() or image.exists())
inv-dh-bodstr-01: The body structure shall at least have a location or a description (location.exists() or description.exists())
2. BodyStructure.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. BodyStructure.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. BodyStructure.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. BodyStructure.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. BodyStructure.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. BodyStructure.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. BodyStructure.extension
Definition

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.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. BodyStructure.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. BodyStructure.identifier
Definition

Identifier for this instance of the anatomical structure.

ShortBodystructure identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. BodyStructure.active
Definition

Whether this body site is in active use.

ShortWhether this record is in active use
Comments

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

Control0..1
Typeboolean
Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to be able to mark a body site entry as not to be used because it was created in error.

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
Fixed Valuetrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. BodyStructure.morphology
Definition

The kind of structure being represented by the body structure at BodyStructure.location. This can define both normal and abnormal morphologies.

ShortKind of Structure
Comments

The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology.

Control0..1
BindingThe codes SHOULD be taken from SNOMEDCTMorphologicAbnormalities
(preferred to http://hl7.org/fhir/ValueSet/bodystructure-code)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. BodyStructure.location
Definition

The anatomical location or region of the specimen, lesion, or body structure.

ShortBody site
Control0..1
This element is affected by the following invariants: inv-bodstr-0, inv-dh-bodstr-02
BindingUnless not suitable, these codes SHALL be taken from Body Site .
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-bodstr-02: If a coded body site is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
26. BodyStructure.locationQualifier
Definition

Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

ShortBody site modifier
Control0..*
This element is affected by the following invariants: inv-dh-bodstr-03
BindingUnless not suitable, these codes SHALL be taken from Body Site Relative Site Qualifier .
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-relative-site-qualifier-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-bodstr-03: If a coded location qualifier is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
28. BodyStructure.description
Definition

A summary, characterization or explanation of the body structure.

ShortText description
Comments

This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.

Control0..1
This element is affected by the following invariants: inv-bodstr-0, inv-dh-bodstr-01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. BodyStructure.image
Definition

Image or images used to identify a location.

ShortAttached images
Control0..*
This element is affected by the following invariants: inv-bodstr-0
TypeAttachment
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. BodyStructure.patient
Definition

The person to which the body site belongs.

ShortWho this is about
Control1..1
This element is affected by the following invariants: inv-dh-bodstr-04
TypeReference(ADHA Core Patient)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-bodstr-04: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())