Australian Digital Health Agency FHIR Implementation Guide
1.2.0-ci-build - draft Australia flag

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: ADHACompositionCOCS - Detailed Descriptions

Draft as of 2024-09-12

Definitions for the dh-composition-cocs-1 resource profile.

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

0. Composition
Definition

A continuity of care summary document support the exchange of core, common, or critical information for exchange between healthcare providers, and individual, to support continuity of care across encounters and healthcare settings. Specific use cases are supported by defined profiles for those use cases such as Shared Health Summary, Event Summary, Discharge Summary, Transfer Summary, Referral; where available the most specific applicable profile should be used.

ShortContinuity of Care Summary
2. Composition.status
Pattern Valuefinal
4. Composition.author
TypeReference(ADHA Authoring PractitionerRole)
6. Composition.section
Invariantsinv-dh-cocs-01: A section shall at least have an entry or an empty reason (entry.exists() or emptyReason.exists())
inv-dh-cocs-02: All observations shall conform one of: ADHA Simple Observation, ADHA Diagnostic Result Observation (entry.resolve().where($this is Observation).exists() implies entry.resolve().conformsTo('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-1'))
SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ code
  • 8. Composition.section:reasonForReferral
    Slice NamereasonForReferral
    Definition

    TBD

    ShortReason for referral
    Control0..1
    10. Composition.section:reasonForReferral.title
    Control1..?
    12. Composition.section:reasonForReferral.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 42349-1 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "42349-1"
      }]
    }
    14. Composition.section:reasonForReferral.entry
    TypeReference(ADHA Core ServiceRequest)
    16. Composition.section:reasonForReferral.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    18. Composition.section:advanceCareDirectives
    Slice NameadvanceCareDirectives
    Definition

    TBD

    ShortInformation on advance care directives.
    Control0..1
    20. Composition.section:advanceCareDirectives.title
    Control1..?
    22. Composition.section:advanceCareDirectives.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 42348-3 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "42348-3"
      }]
    }
    24. Composition.section:advanceCareDirectives.entry
    TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-consent-core-1, ADHA Core DocumentReference, ADHA Advance Care Planning Document DocumentReference)
    26. Composition.section:advanceCareDirectives.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    28. Composition.section:allergies
    Slice Nameallergies
    Definition

    Information about allergies or intolerances identified or reported during this encounter. This may include statements that a patient does not have an allergy or category of allergies.

    ShortAllergies
    Control0..1
    30. Composition.section:allergies.title
    Control1..?
    32. Composition.section:allergies.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 48765-2 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA), and C-CDA on FHIR.

    The use of concept 101.20113 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "48765-2"
      }]
    }
    34. Composition.section:allergies.entry
    TypeReference(ADHA Core AllergyIntolerance)
    36. Composition.section:allergies.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    38. Composition.section:vitalSigns
    Slice NamevitalSigns
    Definition

    Vital signs associated with a patient.

    ShortVital signs
    Control0..1
    40. Composition.section:vitalSigns.title
    Control1..?
    42. Composition.section:vitalSigns.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 8716-3 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "8716-3"
      }]
    }
    44. Composition.section:vitalSigns.entry
    TypeReference(http://hl7.org.au/fhir/core/StructureDefinition/au-core-vitalspanel, AU Core Blood Pressure, AU Core Body Weight, AU Core Body Height, http://hl7.org.au/fhir/core/StructureDefinition/au-core-bmi, http://hl7.org.au/fhir/core/StructureDefinition/au-core-oxygensat, http://hl7.org.au/fhir/core/StructureDefinition/au-core-headcircum, AU Core Heart Rate, AU Core Body Temperature, AU Core Respiration Rate)
    46. Composition.section:vitalSigns.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    48. Composition.section:medicines
    Slice Namemedicines
    Definition

    A description of a patient's medicine use at a point in time. The list may be partial, or complete, and may be a history or scoped to may be taking the medication now or has taken the medication in the past or will be taking the medication in the future.

    ShortMedicines
    Control0..1
    Invariantsinv-dh-cocs-04: At most one assertion of no relevant finding shall be present and it shall assert no known current medications (entry.resolve().where($this is Observation).exists() implies (entry.count() < 2 and (entry.resolve().valueCodeableConcept.coding.code) = '1200661000168107'))
    inv-dh-cocs-05: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
    50. Composition.section:medicines.title
    Control1..?
    52. Composition.section:medicines.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 10160-0 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

    The use of concept 101.16146 or 101.16022 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "10160-0"
      }]
    }
    54. Composition.section:medicines.entry
    TypeReference(ADHA Medication Use List, ADHA Core MedicationStatement, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding)
    56. Composition.section:medicines.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    58. Composition.section:immunisations
    Slice Nameimmunisations
    Definition

    Information about the immunisation history, i.e. administered vaccines, of a patient.

    ShortImmunisations
    Control0..1
    Invariantsinv-dh-cocs-08: At most one assertion of no relevant finding shall be present and it shall assert no history of vaccination (entry.resolve().where($this is Observation).exists() implies (entry.count() < 2 and (entry.resolve().valueCodeableConcept.coding.code) = '1234401000168109'))
    inv-dh-cocs-09: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
    60. Composition.section:immunisations.title
    Control1..?
    62. Composition.section:immunisations.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 11369-6 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    The use of concept 101.16638 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "11369-6"
      }]
    }
    64. Composition.section:immunisations.entry
    TypeReference(ADHA Immunisation History List, ADHA Core Immunization, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding)
    66. Composition.section:immunisations.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    68. Composition.section:problems
    Slice Nameproblems
    Definition

    Information about the clinical problems or conditions currently being monitored for a patient.

    ShortProblems or Diagnoses
    Comments

    The inclusion of a problems section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR.

    The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

    Control0..1
    Invariantsinv-dh-cocs-07: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
    70. Composition.section:problems.title
    Control1..?
    72. Composition.section:problems.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 11450-4 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "11450-4"
      }]
    }
    74. Composition.section:problems.entry
    TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-condition-1, ADHA Core Condition)
    76. Composition.section:problems.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    78. Composition.section:pastMedicalHistory
    Slice NamepastMedicalHistory
    Definition

    Information about the history of past illness for a patient including the history related to their current complaints, problems, or diagnoses.

    ShortPast medical history
    Comments

    The inclusion of a past medical history section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR, and National guidelines for on-screen presentation of discharge summaries' published by the Australian Commission on Safety and Quality in Health Care in August 2016.

    The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

    Control0..1
    Invariantsinv-dh-cocs-03: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
    80. Composition.section:pastMedicalHistory.title
    Control1..?
    82. Composition.section:pastMedicalHistory.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 11348-0 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "11348-0"
      }]
    }
    84. Composition.section:pastMedicalHistory.entry
    TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-condition-1, ADHA Core Condition)
    86. Composition.section:pastMedicalHistory.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    88. Composition.section:procedures
    Slice Nameprocedures
    Definition

    Information about the clinical problems or conditions currently being monitored for a patient.

    ShortProcedures
    Comments

    The inclusion of a problems section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR, and National guidelines for on-screen presentation of discharge summaries' published by the Australian Commission on Safety and Quality in Health Care in August 2016.

    The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

    Control0..1
    Invariantsinv-dh-cocs-06: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
    90. Composition.section:procedures.title
    Control1..?
    92. Composition.section:procedures.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 47519-4 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "47519-4"
      }]
    }
    94. Composition.section:procedures.entry
    TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-procedure-1, ADHA Core Procedure)
    96. Composition.section:procedures.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    98. Composition.section:functionalStatus
    Slice NamefunctionalStatus
    Definition

    Information about the patient's status of normal functioning at the time the record was created. Functional statuses include information regarding the patient relative to ambulatory ability, mental status or competency, activities of daily living (ADLs) (i.e. bathing, dressing, feeding, grooming), home/living situation having an effect on the health status of the patient, ability to care for self, social activity (i.e. issues with social cognition, participation with friends and acquaintances other than family members), occupation activity (i.e. activities partly or directly related to working), housework or volunteering, family and home responsibilities or activities related to home and family, communication ability (i.e. issues with speech, writing or cognition required for communication), and perception, including sight, hearing, taste, skin sensation, kinesthetic sense, proprioception, or balance.

    ShortFunctional Status
    Control0..1
    100. Composition.section:functionalStatus.title
    Control1..?
    102. Composition.section:functionalStatus.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 46264-8 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "46264-8"
      }]
    }
    104. Composition.section:functionalStatus.entry
    TypeReference(ADHA Core Observation, ADHA Core Condition)
    106. Composition.section:functionalStatus.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    108. Composition.section:familyHistory
    Slice NamefamilyHistory
    Definition

    Information about the family history of a patient.

    ShortFamily History
    Control0..1
    110. Composition.section:familyHistory.title
    Control1..?
    112. Composition.section:familyHistory.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 10157-6 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "10157-6"
      }]
    }
    114. Composition.section:familyHistory.entry
    TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-familyhistory-core-1)
    116. Composition.section:familyHistory.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    118. Composition.section:socialHistory
    Slice NamesocialHistory
    Definition

    Information about a patient's health related lifestyle factors or lifestyle observations (e.g. smoke habits; alcohol consumption; diets, risky habits.).

    ShortSocial History (Lifestyle factors)
    Control0..1
    120. Composition.section:socialHistory.title
    Control1..?
    122. Composition.section:socialHistory.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 29762-2 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "29762-2"
      }]
    }
    124. Composition.section:socialHistory.entry
    TypeReference(ADHA Core Observation, http://hl7.org.au/fhir/core/StructureDefinition/au-core-alcoholstatus, AU Core Smoking Status, http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingstartdate, http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingceasedate)
    126. Composition.section:socialHistory.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    128. Composition.section:medicalDevices
    Slice NamemedicalDevices
    Definition

    Information about the medical device (medical equipment) use defines a patient's implanted and external medical devices and equipment that their health status depends on, as well as any pertinent equipment or device history.

    ShortMedical devices
    Control0..1
    Invariantsinv-dh-cocs-10: At most one assertion of no relevant finding shall be present (entry.resolve().where($this is Observation).exists() implies entry.count() < 2)
    130. Composition.section:medicalDevices.title
    Control1..?
    132. Composition.section:medicalDevices.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 46264-8 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "46264-8"
      }]
    }
    134. Composition.section:medicalDevices.entry
    TypeReference(ADHA Implantable Medical Device, http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-device-wearable-1, http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-deviceusestatement-core-1, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding)
    136. Composition.section:medicalDevices.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
    138. Composition.section:diagnosticInvestigations
    Slice NamediagnosticInvestigations
    Definition

    Information about diagnostic tests or procedures performed on or requested for an individual, that are considered relevant to the individual's ongoing care. This does not include a full list of diagnostic tests and procedures performed on or request for the individual but only those that are relevant to the encounter.

    ShortDiagnostic Investigations (Editorial Note: The design of this section is incomplete.
    Control0..1
    140. Composition.section:diagnosticInvestigations.title
    Control1..?
    142. Composition.section:diagnosticInvestigations.code
    Comments

    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

    The LOINC concept 30954-2 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

    The use of concept 101.20117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "30954-2"
      }]
    }
    144. Composition.section:diagnosticInvestigations.entry
    ShortDiagnostic investigations
    TypeReference(ADHA Core DiagnosticReport, ADHA Diagnostic Result Observation, ADHA Imaging Result Observation, ADHA Pathology Result Observation)
    146. Composition.section:diagnosticInvestigations.emptyReason
    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)

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

    0. Composition
    Definition

    A continuity of care summary document support the exchange of core, common, or critical information for exchange between healthcare providers, and individual, to support continuity of care across encounters and healthcare settings. Specific use cases are supported by defined profiles for those use cases such as Shared Health Summary, Event Summary, Discharge Summary, Transfer Summary, Referral; where available the most specific applicable profile should be used.


    A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

    ShortContinuity of Care SummaryA set of resources composed into a single coherent clinical statement with clinical attestation
    Comments

    While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

    Control0..*
    Is Modifierfalse
    Summaryfalse
    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-dh-doc-01: If present, an information recipient shall at least have a reference, an identifier or a display (informationRecipient.exists() implies informationRecipient.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists()))
    inv-dh-doc-02: Sections shall be unique by code (section.select(code.coding.code).isDistinct())
    2. Composition.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. Composition.extension:informationRecipient
    Slice NameinformationRecipient
    Definition

    A recipient who should receive a copy of the composition. A recipient is an entity to whom a copy of the composition is directed at the time of authoring of the composition.

    ShortInformation recipient
    Control0..*
    This element is affected by the following invariants: ele-1, inv-dh-doc-01
    TypeExtension(Information Recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    6. Composition.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())
    8. Composition.identifier
    Definition

    A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

    ShortVersion-independent identifier for the Composition
    Comments

    Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Composition.status
    Definition

    The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

    Shortpreliminary | final | amended | entered-in-error
    Comments

    If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

    Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

    Control1..1
    BindingThe codes SHALL be taken from CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

    The workflow/clinical status of the composition.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to be able to mark interim, amended, or withdrawn compositions or documents.

    Pattern Valuefinal
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Composition.type
    Definition

    Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

    ShortDocument sub typeKind of composition (LOINC if possible)
    Comments

    For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from My Health Record Record Type .http://hl7.org/fhir/ValueSet/doc-typecodes
    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-type-1)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Key metadata element describing the composition, used in searching/filtering.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Composition.category
    Definition

    A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

    ShortCategorization of Composition
    Comments

    This is a metadata field from XDS/MHD.

    Control10..*
    BindingUnless not suitable, these codes SHALL be taken from For example codes, see My Health Record Record Class .http://hl7.org/fhir/ValueSet/document-classcodes
    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-class-1)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Composition.subject
    Definition

    Who or what the composition is about. The composition 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 livestock, or a set of patients that share a common exposure).

    ShortWho and/or what the composition is about
    Comments

    For clinical documents, this is usually the patient.

    Control10..1
    This element is affected by the following invariants: inv-dh-doc-03
    TypeReference(ADHA Core Patient, Resource)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-doc-03: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
    18. Composition.encounter
    Definition

    Describes the clinical encounter or type of care this documentation is associated with.

    ShortContext of the Composition
    Control0..1
    TypeReference(ADHA Core Encounter, Encounter)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Provides context for the composition and supports searching.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Composition.date
    Definition

    The composition editing time, when the composition was last logically changed by the author.

    ShortComposition editing time
    Comments

    The Last Modified Date on the composition may be after the date of the document was attested without being changed.

    Control1..1
    This element is affected by the following invariants: inv-dh-doc-07
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.


    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-doc-07: Date shall be at least to day (toString().length() >= 10)
    22. Composition.author
    Definition

    Identifies who is responsible for the information in the composition, not necessarily who typed it in.

    ShortWho and/or what authored the composition
    Control1..*
    This element is affected by the following invariants: inv-dh-doc-04
    TypeReference(ADHA Authoring PractitionerRole, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Identifies who is responsible for the content.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-doc-04: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
    24. Composition.title
    Definition

    Official human-readable label for the composition.

    ShortHuman Readable name/title
    Comments

    For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

    Control1..1
    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()))
    26. Composition.confidentiality
    Definition

    The code specifying the level of confidentiality of the Composition.

    ShortAs defined by affinity domain
    Comments

    The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

    Control0..01
    BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26
    (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

    Codes specifying the level of confidentiality of the composition.

    Typecode
    Is Modifierfalse
    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()))
    28. Composition.attester
    Definition

    A participant who has attested to the accuracy of the composition/document.

    ShortAttests to accuracy of composition
    Comments

    Only list each attester once.

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Identifies responsibility for the accuracy of the composition content.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-doc-05: The party shall at least have a reference or a valid identifier (party.reference.exists() or party.identifier.where(system.count() + value.count() >1).exists())
    30. Composition.attester.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored even if unrecognized
    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 element that contains them
    Summarytrue
    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, modifiers
    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())
    32. Composition.attester.mode
    Definition

    The type of attestation the authenticator offers.

    Shortpersonal | professional | legal | official
    Control1..1
    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

    The way in which a person authenticated a composition.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Requirements

    Indicates the level of authority of the attestation.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Composition.attester.time
    Definition

    When the composition was attested by the party.

    ShortWhen the composition was attested
    Control10..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Requirements

    Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Composition.attester.party
    Definition

    Who attested the composition in the specified way.

    ShortWho attested the composition
    Control10..1
    This element is affected by the following invariants: inv-dh-doc-05
    TypeReference(ADHA Authoring PractitionerRole, ADHA Core Patient, ADHA Authoring RelatedPerson, ADHA Core Organization, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Requirements

    Identifies who has taken on the responsibility for accuracy of the composition content.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Composition.custodian
    Definition

    Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

    ShortOrganization which maintains the composition
    Comments

    This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

    Control10..1
    This element is affected by the following invariants: inv-dh-doc-06
    TypeReference(ADHA Core Organization, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Identifies where to go to find the current version, where to report issues, etc.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-doc-06: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
    40. Composition.relatesTo
    Definition

    Relationships that this composition has with other compositions or documents that already exist.

    ShortRelationships to other compositions/documents
    Comments

    A document is a version specific composition.

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Composition.relatesTo.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored even if unrecognized
    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 element that contains them
    Summarytrue
    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, modifiers
    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())
    44. Composition.relatesTo.code
    Definition

    The type of relationship that this composition has with anther composition or document.

    Shortreplaces | transforms | signs | appends
    Comments

    If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

    Control1..1
    BindingThe codes SHALL be taken from DocumentRelationshipTypehttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

    The type of relationship between documents.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Composition.relatesTo.target[x]
    Definition

    The target composition/document of this relationship.

    ShortTarget of the relationship
    Control1..1
    TypeChoice of: Identifier, Reference(ADHA Core Composition, Composition)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Composition.section
    Definition

    The root of the sections that make up the composition.

    ShortComposition is broken into sections
    Control10..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-cocs-01: A section shall at least have an entry or an empty reason (entry.exists() or emptyReason.exists())
    inv-dh-cocs-02: All observations shall conform one of: ADHA Simple Observation, ADHA Diagnostic Result Observation (entry.resolve().where($this is Observation).exists() implies entry.resolve().conformsTo('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-1'))
    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
    SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ code
    • 50. Composition.section.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      52. Composition.section.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Composition.section.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control0..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Composition.section.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. Composition.section.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2
      TypeReference(Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. Composition.section.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      62. Composition.section.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2
      BindingThe codes SHOULD be taken from ListEmptyReasonshttp://hl7.org/fhir/ValueSet/list-empty-reason
      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

      If a section is empty, why it is empty.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. Composition.section:reasonForReferral
      Slice NamereasonForReferral
      Definition

      TBD


      The root of the sections that make up the composition.

      ShortReason for referralComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      66. Composition.section:reasonForReferral.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      68. Composition.section:reasonForReferral.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      70. Composition.section:reasonForReferral.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 42349-1 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "42349-1"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. Composition.section:reasonForReferral.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. Composition.section:reasonForReferral.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
      TypeReference(ADHA Core ServiceRequest, Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. Composition.section:reasonForReferral.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      78. Composition.section:reasonForReferral.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      80. Composition.section:advanceCareDirectives
      Slice NameadvanceCareDirectives
      Definition

      TBD


      The root of the sections that make up the composition.

      ShortInformation on advance care directives.Composition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      82. Composition.section:advanceCareDirectives.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      84. Composition.section:advanceCareDirectives.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      86. Composition.section:advanceCareDirectives.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 42348-3 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "42348-3"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      88. Composition.section:advanceCareDirectives.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      90. Composition.section:advanceCareDirectives.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
      TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-consent-core-1, ADHA Core DocumentReference, ADHA Advance Care Planning Document DocumentReference, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      92. Composition.section:advanceCareDirectives.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      94. Composition.section:advanceCareDirectives.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      96. Composition.section:allergies
      Slice Nameallergies
      Definition

      Information about allergies or intolerances identified or reported during this encounter. This may include statements that a patient does not have an allergy or category of allergies.


      The root of the sections that make up the composition.

      ShortAllergiesComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      98. Composition.section:allergies.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      100. Composition.section:allergies.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      102. Composition.section:allergies.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 48765-2 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA), and C-CDA on FHIR.

      The use of concept 101.20113 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "48765-2"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      104. Composition.section:allergies.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      106. Composition.section:allergies.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
      TypeReference(ADHA Core AllergyIntolerance, Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      108. Composition.section:allergies.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      110. Composition.section:allergies.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      112. Composition.section:vitalSigns
      Slice NamevitalSigns
      Definition

      Vital signs associated with a patient.


      The root of the sections that make up the composition.

      ShortVital signsComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      114. Composition.section:vitalSigns.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      116. Composition.section:vitalSigns.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      118. Composition.section:vitalSigns.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 8716-3 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "8716-3"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      120. Composition.section:vitalSigns.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      122. Composition.section:vitalSigns.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
      TypeReference(http://hl7.org.au/fhir/core/StructureDefinition/au-core-vitalspanel, AU Core Blood Pressure, AU Core Body Weight, AU Core Body Height, http://hl7.org.au/fhir/core/StructureDefinition/au-core-bmi, http://hl7.org.au/fhir/core/StructureDefinition/au-core-oxygensat, http://hl7.org.au/fhir/core/StructureDefinition/au-core-headcircum, AU Core Heart Rate, AU Core Body Temperature, AU Core Respiration Rate, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      124. Composition.section:vitalSigns.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      126. Composition.section:vitalSigns.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      128. Composition.section:medicines
      Slice Namemedicines
      Definition

      A description of a patient's medicine use at a point in time. The list may be partial, or complete, and may be a history or scoped to may be taking the medication now or has taken the medication in the past or will be taking the medication in the future.


      The root of the sections that make up the composition.

      ShortMedicinesComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      inv-dh-cocs-04: At most one assertion of no relevant finding shall be present and it shall assert no known current medications (entry.resolve().where($this is Observation).exists() implies (entry.count() < 2 and (entry.resolve().valueCodeableConcept.coding.code) = '1200661000168107'))
      inv-dh-cocs-05: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      130. Composition.section:medicines.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      132. Composition.section:medicines.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      134. Composition.section:medicines.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 10160-0 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

      The use of concept 101.16146 or 101.16022 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "10160-0"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      136. Composition.section:medicines.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      138. Composition.section:medicines.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-04, inv-dh-cocs-05
      TypeReference(ADHA Medication Use List, ADHA Core MedicationStatement, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      140. Composition.section:medicines.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      142. Composition.section:medicines.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      144. Composition.section:immunisations
      Slice Nameimmunisations
      Definition

      Information about the immunisation history, i.e. administered vaccines, of a patient.


      The root of the sections that make up the composition.

      ShortImmunisationsComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      inv-dh-cocs-08: At most one assertion of no relevant finding shall be present and it shall assert no history of vaccination (entry.resolve().where($this is Observation).exists() implies (entry.count() < 2 and (entry.resolve().valueCodeableConcept.coding.code) = '1234401000168109'))
      inv-dh-cocs-09: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      146. Composition.section:immunisations.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      148. Composition.section:immunisations.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      150. Composition.section:immunisations.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 11369-6 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      The use of concept 101.16638 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "11369-6"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      152. Composition.section:immunisations.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      154. Composition.section:immunisations.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-08, inv-dh-cocs-09
      TypeReference(ADHA Immunisation History List, ADHA Core Immunization, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      156. Composition.section:immunisations.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      158. Composition.section:immunisations.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      160. Composition.section:problems
      Slice Nameproblems
      Definition

      Information about the clinical problems or conditions currently being monitored for a patient.


      The root of the sections that make up the composition.

      ShortProblems or DiagnosesComposition is broken into sections
      Comments

      The inclusion of a problems section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR.

      The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      inv-dh-cocs-07: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      162. Composition.section:problems.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      164. Composition.section:problems.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      166. Composition.section:problems.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 11450-4 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "11450-4"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      168. Composition.section:problems.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      170. Composition.section:problems.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-07
      TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-condition-1, ADHA Core Condition, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      172. Composition.section:problems.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      174. Composition.section:problems.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      176. Composition.section:pastMedicalHistory
      Slice NamepastMedicalHistory
      Definition

      Information about the history of past illness for a patient including the history related to their current complaints, problems, or diagnoses.


      The root of the sections that make up the composition.

      ShortPast medical historyComposition is broken into sections
      Comments

      The inclusion of a past medical history section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR, and National guidelines for on-screen presentation of discharge summaries' published by the Australian Commission on Safety and Quality in Health Care in August 2016.

      The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      inv-dh-cocs-03: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      178. Composition.section:pastMedicalHistory.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      180. Composition.section:pastMedicalHistory.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      182. Composition.section:pastMedicalHistory.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 11348-0 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "11348-0"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      184. Composition.section:pastMedicalHistory.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      186. Composition.section:pastMedicalHistory.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-03
      TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-condition-1, ADHA Core Condition, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      188. Composition.section:pastMedicalHistory.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      190. Composition.section:pastMedicalHistory.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      192. Composition.section:procedures
      Slice Nameprocedures
      Definition

      Information about the clinical problems or conditions currently being monitored for a patient.


      The root of the sections that make up the composition.

      ShortProceduresComposition is broken into sections
      Comments

      The inclusion of a problems section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR, and National guidelines for on-screen presentation of discharge summaries' published by the Australian Commission on Safety and Quality in Health Care in August 2016.

      The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      inv-dh-cocs-06: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      194. Composition.section:procedures.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      196. Composition.section:procedures.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      198. Composition.section:procedures.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 47519-4 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "47519-4"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      200. Composition.section:procedures.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      202. Composition.section:procedures.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-06
      TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-procedure-1, ADHA Core Procedure, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      204. Composition.section:procedures.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      206. Composition.section:procedures.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      208. Composition.section:functionalStatus
      Slice NamefunctionalStatus
      Definition

      Information about the patient's status of normal functioning at the time the record was created. Functional statuses include information regarding the patient relative to ambulatory ability, mental status or competency, activities of daily living (ADLs) (i.e. bathing, dressing, feeding, grooming), home/living situation having an effect on the health status of the patient, ability to care for self, social activity (i.e. issues with social cognition, participation with friends and acquaintances other than family members), occupation activity (i.e. activities partly or directly related to working), housework or volunteering, family and home responsibilities or activities related to home and family, communication ability (i.e. issues with speech, writing or cognition required for communication), and perception, including sight, hearing, taste, skin sensation, kinesthetic sense, proprioception, or balance.


      The root of the sections that make up the composition.

      ShortFunctional StatusComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      210. Composition.section:functionalStatus.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      212. Composition.section:functionalStatus.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      214. Composition.section:functionalStatus.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 46264-8 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "46264-8"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      216. Composition.section:functionalStatus.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      218. Composition.section:functionalStatus.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-10
      TypeReference(ADHA Core Observation, ADHA Core Condition, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      220. Composition.section:functionalStatus.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      222. Composition.section:functionalStatus.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      224. Composition.section:familyHistory
      Slice NamefamilyHistory
      Definition

      Information about the family history of a patient.


      The root of the sections that make up the composition.

      ShortFamily HistoryComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      226. Composition.section:familyHistory.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      228. Composition.section:familyHistory.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      230. Composition.section:familyHistory.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 10157-6 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "10157-6"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      232. Composition.section:familyHistory.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      234. Composition.section:familyHistory.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2
      TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-familyhistory-core-1, Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      236. Composition.section:familyHistory.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      238. Composition.section:familyHistory.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      240. Composition.section:socialHistory
      Slice NamesocialHistory
      Definition

      Information about a patient's health related lifestyle factors or lifestyle observations (e.g. smoke habits; alcohol consumption; diets, risky habits.).


      The root of the sections that make up the composition.

      ShortSocial History (Lifestyle factors)Composition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      242. Composition.section:socialHistory.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      244. Composition.section:socialHistory.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      246. Composition.section:socialHistory.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 29762-2 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "29762-2"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      248. Composition.section:socialHistory.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      250. Composition.section:socialHistory.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2
      TypeReference(ADHA Core Observation, http://hl7.org.au/fhir/core/StructureDefinition/au-core-alcoholstatus, AU Core Smoking Status, http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingstartdate, http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingceasedate, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      252. Composition.section:socialHistory.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      254. Composition.section:socialHistory.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      256. Composition.section:medicalDevices
      Slice NamemedicalDevices
      Definition

      Information about the medical device (medical equipment) use defines a patient's implanted and external medical devices and equipment that their health status depends on, as well as any pertinent equipment or device history.


      The root of the sections that make up the composition.

      ShortMedical devicesComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      inv-dh-cocs-10: At most one assertion of no relevant finding shall be present (entry.resolve().where($this is Observation).exists() implies entry.count() < 2)
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      258. Composition.section:medicalDevices.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      260. Composition.section:medicalDevices.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      262. Composition.section:medicalDevices.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 46264-8 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "46264-8"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      264. Composition.section:medicalDevices.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      266. Composition.section:medicalDevices.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-10
      TypeReference(ADHA Implantable Medical Device, http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-device-wearable-1, http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-deviceusestatement-core-1, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      268. Composition.section:medicalDevices.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      270. Composition.section:medicalDevices.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      272. Composition.section:diagnosticInvestigations
      Slice NamediagnosticInvestigations
      Definition

      Information about diagnostic tests or procedures performed on or requested for an individual, that are considered relevant to the individual's ongoing care. This does not include a full list of diagnostic tests and procedures performed on or request for the individual but only those that are relevant to the encounter.


      The root of the sections that make up the composition.

      ShortDiagnostic Investigations (Editorial Note: The design of this section is incomplete.Composition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      274. Composition.section:diagnosticInvestigations.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      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, modifiers
      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())
      276. Composition.section:diagnosticInvestigations.title
      Definition

      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

      ShortLabel for section (e.g. for ToC)
      Comments

      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

      Alternate Namesheader, label, caption
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      278. Composition.section:diagnosticInvestigations.code
      Definition

      A code identifying the kind of content contained within the section. This must be consistent with the section title.

      ShortClassification of section (recommended)
      Comments

      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

      The LOINC concept 30954-2 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

      The use of concept 101.20117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.


      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

      Control10..1
      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

      Classification of a section of a composition/document.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "30954-2"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      280. Composition.section:diagnosticInvestigations.text
      Definition

      A human-readable narrative that contains the attested content of the section, 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.

      ShortText summary of the section, for human interpretation
      Comments

      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

      Control0..1
      This element is affected by the following invariants: cmp-1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      282. Composition.section:diagnosticInvestigations.entry
      Definition

      A reference to the actual resource from which the narrative in the section is derived.

      ShortDiagnostic investigationsA reference to data that supports this section
      Comments

      If there are no entries in the list, an emptyReason SHOULD be provided.

      Control0..*
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
      TypeReference(ADHA Core DiagnosticReport, ADHA Diagnostic Result Observation, ADHA Imaging Result Observation, ADHA Pathology Result Observation, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      284. Composition.section:diagnosticInvestigations.entry.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      286. Composition.section:diagnosticInvestigations.emptyReason
      Definition

      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

      ShortWhy the section is empty
      Comments

      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

      Control0..1
      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
      BindingThe codes SHALL be taken from The codes SHOULD be taken from Health Summary Non-Clinical Empty Reason .http://hl7.org/fhir/ValueSet/list-empty-reason
      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

      0. Composition
      Definition

      A continuity of care summary document support the exchange of core, common, or critical information for exchange between healthcare providers, and individual, to support continuity of care across encounters and healthcare settings. Specific use cases are supported by defined profiles for those use cases such as Shared Health Summary, Event Summary, Discharge Summary, Transfer Summary, Referral; where available the most specific applicable profile should be used.

      ShortContinuity of Care Summary
      Comments

      While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

      Control0..*
      Is Modifierfalse
      Summaryfalse
      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-dh-doc-01: If present, an information recipient shall at least have a reference, an identifier or a display (informationRecipient.exists() implies informationRecipient.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists()))
      inv-dh-doc-02: Sections shall be unique by code (section.select(code.coding.code).isDistinct())
      2. Composition.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. Composition.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. Composition.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. Composition.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. Composition.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. Composition.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. Composition.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      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())
      SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Composition.extension:informationRecipient
        Slice NameinformationRecipient
        Definition

        A recipient who should receive a copy of the composition. A recipient is an entity to whom a copy of the composition is directed at the time of authoring of the composition.

        ShortInformation recipient
        Control0..*
        This element is affected by the following invariants: ele-1, inv-dh-doc-01
        TypeExtension(Information Recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
        Is Modifierfalse
        Must Supporttrue
        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. Composition.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())
        20. Composition.identifier
        Definition

        A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

        ShortVersion-independent identifier for the Composition
        Comments

        Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..1
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Composition.status
        Definition

        The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

        Shortpreliminary | final | amended | entered-in-error
        Comments

        If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

        Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

        Control1..1
        BindingThe codes SHALL be taken from CompositionStatus
        (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

        The workflow/clinical status of the composition.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to mark interim, amended, or withdrawn compositions or documents.

        Pattern Valuefinal
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Composition.type
        Definition

        Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

        ShortDocument sub type
        Comments

        For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from My Health Record Record Type .
        (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-type-1)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Key metadata element describing the composition, used in searching/filtering.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Composition.category
        Definition

        A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

        ShortCategorization of Composition
        Comments

        This is a metadata field from XDS/MHD.

        Control1..*
        BindingUnless not suitable, these codes SHALL be taken from My Health Record Record Class .
        (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-class-1)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Composition.subject
        Definition

        Who or what the composition is about. The composition 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 livestock, or a set of patients that share a common exposure).

        ShortWho and/or what the composition is about
        Comments

        For clinical documents, this is usually the patient.

        Control1..1
        This element is affected by the following invariants: inv-dh-doc-03
        TypeReference(ADHA Core Patient)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        inv-dh-doc-03: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
        30. Composition.encounter
        Definition

        Describes the clinical encounter or type of care this documentation is associated with.

        ShortContext of the Composition
        Control0..1
        TypeReference(ADHA Core Encounter)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Provides context for the composition and supports searching.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Composition.date
        Definition

        The composition editing time, when the composition was last logically changed by the author.

        ShortComposition editing time
        Comments

        The Last Modified Date on the composition may be after the date of the document was attested without being changed.

        Control1..1
        This element is affected by the following invariants: inv-dh-doc-07
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        inv-dh-doc-07: Date shall be at least to day (toString().length() >= 10)
        34. Composition.author
        Definition

        Identifies who is responsible for the information in the composition, not necessarily who typed it in.

        ShortWho and/or what authored the composition
        Control1..*
        This element is affected by the following invariants: inv-dh-doc-04
        TypeReference(ADHA Authoring PractitionerRole)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Identifies who is responsible for the content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        inv-dh-doc-04: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
        36. Composition.title
        Definition

        Official human-readable label for the composition.

        ShortHuman Readable name/title
        Comments

        For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

        Control1..1
        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()))
        38. Composition.confidentiality
        Definition

        The code specifying the level of confidentiality of the Composition.

        ShortAs defined by affinity domain
        Comments

        The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

        Control0..0
        BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
        (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

        Codes specifying the level of confidentiality of the composition.

        Typecode
        Is Modifierfalse
        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()))
        40. Composition.attester
        Definition

        A participant who has attested to the accuracy of the composition/document.

        ShortAttests to accuracy of composition
        Comments

        Only list each attester once.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Identifies responsibility for the accuracy of the composition content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        inv-dh-doc-05: The party shall at least have a reference or a valid identifier (party.reference.exists() or party.identifier.where(system.count() + value.count() >1).exists())
        42. Composition.attester.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        44. Composition.attester.extension
        Definition

        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.

        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())
        46. Composition.attester.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        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 element that contains them
        Summarytrue
        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, modifiers
        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())
        48. Composition.attester.mode
        Definition

        The type of attestation the authenticator offers.

        Shortpersonal | professional | legal | official
        Control1..1
        BindingThe codes SHALL be taken from CompositionAttestationMode
        (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

        The way in which a person authenticated a composition.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        Indicates the level of authority of the attestation.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Composition.attester.time
        Definition

        When the composition was attested by the party.

        ShortWhen the composition was attested
        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Composition.attester.party
        Definition

        Who attested the composition in the specified way.

        ShortWho attested the composition
        Control1..1
        This element is affected by the following invariants: inv-dh-doc-05
        TypeReference(ADHA Authoring PractitionerRole, ADHA Core Patient, ADHA Authoring RelatedPerson, ADHA Core Organization)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summaryfalse
        Requirements

        Identifies who has taken on the responsibility for accuracy of the composition content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Composition.custodian
        Definition

        Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

        ShortOrganization which maintains the composition
        Comments

        This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

        Control1..1
        This element is affected by the following invariants: inv-dh-doc-06
        TypeReference(ADHA Core Organization)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Identifies where to go to find the current version, where to report issues, etc.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        inv-dh-doc-06: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
        56. Composition.relatesTo
        Definition

        Relationships that this composition has with other compositions or documents that already exist.

        ShortRelationships to other compositions/documents
        Comments

        A document is a version specific composition.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Composition.relatesTo.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        60. Composition.relatesTo.extension
        Definition

        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.

        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())
        62. Composition.relatesTo.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        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 element that contains them
        Summarytrue
        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, modifiers
        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())
        64. Composition.relatesTo.code
        Definition

        The type of relationship that this composition has with anther composition or document.

        Shortreplaces | transforms | signs | appends
        Comments

        If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

        Control1..1
        BindingThe codes SHALL be taken from DocumentRelationshipType
        (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

        The type of relationship between documents.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Composition.relatesTo.target[x]
        Definition

        The target composition/document of this relationship.

        ShortTarget of the relationship
        Control1..1
        TypeChoice of: Identifier, Reference(ADHA Core Composition)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Composition.event
        Definition

        The clinical service, such as a colonoscopy or an appendectomy, being documented.

        ShortThe clinical service(s) being documented
        Comments

        The event needs to be consistent with the type element, though can provide further information if desired.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Requirements

        Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Composition.event.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        72. Composition.event.extension
        Definition

        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.

        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())
        74. Composition.event.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        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 element that contains them
        Summarytrue
        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, modifiers
        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())
        76. Composition.event.code
        Definition

        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 typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

        ShortCode(s) that apply to the event being documented
        Comments

        An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

        Control0..*
        BindingFor example codes, see v3 Code System ActCode
        (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

        This list of codes represents the main clinical acts being documented.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Composition.event.period
        Definition

        The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

        ShortThe period covered by the documentation
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Composition.event.detail
        Definition

        The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

        ShortThe event(s) being documented
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Composition.section
        Definition

        The root of the sections that make up the composition.

        ShortComposition is broken into sections
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        inv-dh-cocs-01: A section shall at least have an entry or an empty reason (entry.exists() or emptyReason.exists())
        inv-dh-cocs-02: All observations shall conform one of: ADHA Simple Observation, ADHA Diagnostic Result Observation (entry.resolve().where($this is Observation).exists() implies entry.resolve().conformsTo('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-1'))
        SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • pattern @ code
        • 84. Composition.section.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          86. Composition.section.extension
          Definition

          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.

          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())
          88. Composition.section.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored even if unrecognized
          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 element that contains them
          Summarytrue
          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, modifiers
          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())
          90. Composition.section.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. Composition.section.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control0..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. Composition.section.author
          Definition

          Identifies who is responsible for the information in this section, not necessarily who typed it in.

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. Composition.section.focus
          Definition

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. Composition.section.text
          Definition

          A human-readable narrative that contains the attested content of the section, 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.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control0..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. Composition.section.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

          Fixed Valuesnapshot
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. Composition.section.orderedBy
          Definition

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. Composition.section.entry
          Definition

          A reference to the actual resource from which the narrative in the section is derived.

          ShortA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. Composition.section.entry.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          108. Composition.section.entry.extension
          Definition

          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.

          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())
          SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 110. Composition.section.entry.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control1..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            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()))
            112. Composition.section.entry.type
            Definition

            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

            ShortType the reference refers to (e.g. "Patient")
            Comments

            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from ResourceType
            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

            Aa resource (or, for logical models, the URI of the logical model).

            Typeuri
            Is Modifierfalse
            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()))
            114. Composition.section.entry.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. Composition.section.entry.display
            Definition

            Plain text narrative that identifies the resource in addition to the resource reference.

            ShortText alternative for the resource
            Comments

            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

            Control0..1
            Typestring
            Is Modifierfalse
            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()))
            118. Composition.section.emptyReason
            Definition

            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

            ShortWhy the section is empty
            Comments

            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

            Control0..1
            This element is affected by the following invariants: cmp-2
            BindingThe codes SHOULD be taken from ListEmptyReasons
            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

            If a section is empty, why it is empty.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. Composition.section.section
            Definition

            A nested sub-section within this section.

            ShortNested Section
            Comments

            Nested sections are primarily used to help human readers navigate to particular portions of the document.

            Control0..*
            This element is affected by the following invariants: cmp-1
            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            122. Composition.section:reasonForReferral
            Slice NamereasonForReferral
            Definition

            TBD

            ShortReason for referral
            Control0..1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            124. Composition.section:reasonForReferral.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            126. Composition.section:reasonForReferral.extension
            Definition

            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.

            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())
            128. Composition.section:reasonForReferral.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            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 element that contains them
            Summarytrue
            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, modifiers
            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())
            130. Composition.section:reasonForReferral.title
            Definition

            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

            ShortLabel for section (e.g. for ToC)
            Comments

            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

            Alternate Namesheader, label, caption
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. Composition.section:reasonForReferral.code
            Definition

            A code identifying the kind of content contained within the section. This must be consistent with the section title.

            ShortClassification of section (recommended)
            Comments

            The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

            The LOINC concept 42349-1 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

            Control1..1
            BindingFor example codes, see DocumentSectionCodes
            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

            Classification of a section of a composition/document.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Provides computable standardized labels to topics within the document.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "42349-1"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            134. Composition.section:reasonForReferral.author
            Definition

            Identifies who is responsible for the information in this section, not necessarily who typed it in.

            ShortWho and/or what authored the section
            Control0..*
            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
            Is Modifierfalse
            Summaryfalse
            Requirements

            Identifies who is responsible for the content.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Composition.section:reasonForReferral.focus
            Definition

            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

            ShortWho/what the section is about, when it is not about the subject of composition
            Comments

            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

            Control0..1
            TypeReference(Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            138. Composition.section:reasonForReferral.text
            Definition

            A human-readable narrative that contains the attested content of the section, 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.

            ShortText summary of the section, for human interpretation
            Comments

            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

            Control0..1
            This element is affected by the following invariants: cmp-1
            TypeNarrative
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            140. Composition.section:reasonForReferral.mode
            Definition

            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

            Shortworking | snapshot | changes
            Comments

            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

            Control0..1
            BindingThe codes SHALL be taken from ListMode
            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

            The processing mode that applies to this section.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

            Fixed Valuesnapshot
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            142. Composition.section:reasonForReferral.orderedBy
            Definition

            Specifies the order applied to the items in the section entries.

            ShortOrder of section entries
            Comments

            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

            Control0..1
            BindingThe codes SHOULD be taken from ListOrderCodes
            (preferred to http://hl7.org/fhir/ValueSet/list-order)

            What order applies to the items in the entry.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            144. Composition.section:reasonForReferral.entry
            Definition

            A reference to the actual resource from which the narrative in the section is derived.

            ShortA reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..*
            This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
            TypeReference(ADHA Core ServiceRequest)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. Composition.section:reasonForReferral.entry.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            148. Composition.section:reasonForReferral.entry.extension
            Definition

            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.

            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())
            SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 150. Composition.section:reasonForReferral.entry.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control1..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              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()))
              152. Composition.section:reasonForReferral.entry.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              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()))
              154. Composition.section:reasonForReferral.entry.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              156. Composition.section:reasonForReferral.entry.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..1
              Typestring
              Is Modifierfalse
              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()))
              158. Composition.section:reasonForReferral.emptyReason
              Definition

              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

              ShortWhy the section is empty
              Comments

              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

              Control0..1
              This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
              BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
              (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              160. Composition.section:reasonForReferral.section
              Definition

              A nested sub-section within this section.

              ShortNested Section
              Comments

              Nested sections are primarily used to help human readers navigate to particular portions of the document.

              Control0..*
              This element is affected by the following invariants: cmp-1
              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              162. Composition.section:advanceCareDirectives
              Slice NameadvanceCareDirectives
              Definition

              TBD

              ShortInformation on advance care directives.
              Control0..1
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              164. Composition.section:advanceCareDirectives.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              166. Composition.section:advanceCareDirectives.extension
              Definition

              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.

              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())
              168. Composition.section:advanceCareDirectives.modifierExtension
              Definition

              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).

              ShortExtensions that cannot be ignored even if unrecognized
              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 element that contains them
              Summarytrue
              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, modifiers
              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())
              170. Composition.section:advanceCareDirectives.title
              Definition

              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

              ShortLabel for section (e.g. for ToC)
              Comments

              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

              Control1..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

              Alternate Namesheader, label, caption
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              172. Composition.section:advanceCareDirectives.code
              Definition

              A code identifying the kind of content contained within the section. This must be consistent with the section title.

              ShortClassification of section (recommended)
              Comments

              The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

              The LOINC concept 42348-3 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

              Control1..1
              BindingFor example codes, see DocumentSectionCodes
              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

              Classification of a section of a composition/document.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Provides computable standardized labels to topics within the document.

              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "42348-3"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              174. Composition.section:advanceCareDirectives.author
              Definition

              Identifies who is responsible for the information in this section, not necessarily who typed it in.

              ShortWho and/or what authored the section
              Control0..*
              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
              Is Modifierfalse
              Summaryfalse
              Requirements

              Identifies who is responsible for the content.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              176. Composition.section:advanceCareDirectives.focus
              Definition

              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

              ShortWho/what the section is about, when it is not about the subject of composition
              Comments

              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

              Control0..1
              TypeReference(Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              178. Composition.section:advanceCareDirectives.text
              Definition

              A human-readable narrative that contains the attested content of the section, 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.

              ShortText summary of the section, for human interpretation
              Comments

              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

              Control0..1
              This element is affected by the following invariants: cmp-1
              TypeNarrative
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              180. Composition.section:advanceCareDirectives.mode
              Definition

              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

              Shortworking | snapshot | changes
              Comments

              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

              Control0..1
              BindingThe codes SHALL be taken from ListMode
              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

              The processing mode that applies to this section.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

              Fixed Valuesnapshot
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              182. Composition.section:advanceCareDirectives.orderedBy
              Definition

              Specifies the order applied to the items in the section entries.

              ShortOrder of section entries
              Comments

              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

              Control0..1
              BindingThe codes SHOULD be taken from ListOrderCodes
              (preferred to http://hl7.org/fhir/ValueSet/list-order)

              What order applies to the items in the entry.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              184. Composition.section:advanceCareDirectives.entry
              Definition

              A reference to the actual resource from which the narrative in the section is derived.

              ShortA reference to data that supports this section
              Comments

              If there are no entries in the list, an emptyReason SHOULD be provided.

              Control0..*
              This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
              TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-consent-core-1, ADHA Core DocumentReference, ADHA Advance Care Planning Document DocumentReference)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              186. Composition.section:advanceCareDirectives.entry.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              188. Composition.section:advanceCareDirectives.entry.extension
              Definition

              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.

              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())
              SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 190. Composition.section:advanceCareDirectives.entry.reference
                Definition

                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                ShortLiteral reference, Relative, internal or absolute URL
                Comments

                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                Control1..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                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()))
                192. Composition.section:advanceCareDirectives.entry.type
                Definition

                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                ShortType the reference refers to (e.g. "Patient")
                Comments

                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                Aa resource (or, for logical models, the URI of the logical model).

                Typeuri
                Is Modifierfalse
                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()))
                194. Composition.section:advanceCareDirectives.entry.identifier
                Definition

                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                ShortLogical reference, when literal reference is not known
                Comments

                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                196. Composition.section:advanceCareDirectives.entry.display
                Definition

                Plain text narrative that identifies the resource in addition to the resource reference.

                ShortText alternative for the resource
                Comments

                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                Control0..1
                Typestring
                Is Modifierfalse
                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()))
                198. Composition.section:advanceCareDirectives.emptyReason
                Definition

                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                ShortWhy the section is empty
                Comments

                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                Control0..1
                This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                200. Composition.section:advanceCareDirectives.section
                Definition

                A nested sub-section within this section.

                ShortNested Section
                Comments

                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                Control0..*
                This element is affected by the following invariants: cmp-1
                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                202. Composition.section:allergies
                Slice Nameallergies
                Definition

                Information about allergies or intolerances identified or reported during this encounter. This may include statements that a patient does not have an allergy or category of allergies.

                ShortAllergies
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                204. Composition.section:allergies.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                206. Composition.section:allergies.extension
                Definition

                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.

                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())
                208. Composition.section:allergies.modifierExtension
                Definition

                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).

                ShortExtensions that cannot be ignored even if unrecognized
                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 element that contains them
                Summarytrue
                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, modifiers
                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())
                210. Composition.section:allergies.title
                Definition

                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                ShortLabel for section (e.g. for ToC)
                Comments

                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                Control1..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summaryfalse
                Requirements

                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                Alternate Namesheader, label, caption
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                212. Composition.section:allergies.code
                Definition

                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                ShortClassification of section (recommended)
                Comments

                The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                The LOINC concept 48765-2 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA), and C-CDA on FHIR.

                The use of concept 101.20113 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                Control1..1
                BindingFor example codes, see DocumentSectionCodes
                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "48765-2"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                214. Composition.section:allergies.author
                Definition

                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                ShortWho and/or what authored the section
                Control0..*
                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                Is Modifierfalse
                Summaryfalse
                Requirements

                Identifies who is responsible for the content.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                216. Composition.section:allergies.focus
                Definition

                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                ShortWho/what the section is about, when it is not about the subject of composition
                Comments

                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                Control0..1
                TypeReference(Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                218. Composition.section:allergies.text
                Definition

                A human-readable narrative that contains the attested content of the section, 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.

                ShortText summary of the section, for human interpretation
                Comments

                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                Control0..1
                This element is affected by the following invariants: cmp-1
                TypeNarrative
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                220. Composition.section:allergies.mode
                Definition

                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                Shortworking | snapshot | changes
                Comments

                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                Control0..1
                BindingThe codes SHALL be taken from ListMode
                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                The processing mode that applies to this section.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                Fixed Valuesnapshot
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                222. Composition.section:allergies.orderedBy
                Definition

                Specifies the order applied to the items in the section entries.

                ShortOrder of section entries
                Comments

                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                Control0..1
                BindingThe codes SHOULD be taken from ListOrderCodes
                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                What order applies to the items in the entry.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                224. Composition.section:allergies.entry
                Definition

                A reference to the actual resource from which the narrative in the section is derived.

                ShortA reference to data that supports this section
                Comments

                If there are no entries in the list, an emptyReason SHOULD be provided.

                Control0..*
                This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
                TypeReference(ADHA Core AllergyIntolerance)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                226. Composition.section:allergies.entry.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                228. Composition.section:allergies.entry.extension
                Definition

                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.

                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())
                SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 230. Composition.section:allergies.entry.reference
                  Definition

                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                  ShortLiteral reference, Relative, internal or absolute URL
                  Comments

                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                  Control1..1
                  This element is affected by the following invariants: ref-1
                  Typestring
                  Is Modifierfalse
                  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()))
                  232. Composition.section:allergies.entry.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  ShortType the reference refers to (e.g. "Patient")
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Typeuri
                  Is Modifierfalse
                  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()))
                  234. Composition.section:allergies.entry.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                  ShortLogical reference, when literal reference is not known
                  Comments

                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  236. Composition.section:allergies.entry.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  ShortText alternative for the resource
                  Comments

                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  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()))
                  238. Composition.section:allergies.emptyReason
                  Definition

                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                  ShortWhy the section is empty
                  Comments

                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                  Control0..1
                  This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                  BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                  (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  240. Composition.section:allergies.section
                  Definition

                  A nested sub-section within this section.

                  ShortNested Section
                  Comments

                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                  Control0..*
                  This element is affected by the following invariants: cmp-1
                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  242. Composition.section:vitalSigns
                  Slice NamevitalSigns
                  Definition

                  Vital signs associated with a patient.

                  ShortVital signs
                  Control0..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  244. Composition.section:vitalSigns.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  246. Composition.section:vitalSigns.extension
                  Definition

                  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.

                  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())
                  248. Composition.section:vitalSigns.modifierExtension
                  Definition

                  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).

                  ShortExtensions that cannot be ignored even if unrecognized
                  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 element that contains them
                  Summarytrue
                  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, modifiers
                  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())
                  250. Composition.section:vitalSigns.title
                  Definition

                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                  ShortLabel for section (e.g. for ToC)
                  Comments

                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                  Alternate Namesheader, label, caption
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  252. Composition.section:vitalSigns.code
                  Definition

                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                  ShortClassification of section (recommended)
                  Comments

                  The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                  The LOINC concept 8716-3 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                  Control1..1
                  BindingFor example codes, see DocumentSectionCodes
                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                  Classification of a section of a composition/document.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Provides computable standardized labels to topics within the document.

                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "8716-3"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  254. Composition.section:vitalSigns.author
                  Definition

                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                  ShortWho and/or what authored the section
                  Control0..*
                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Identifies who is responsible for the content.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  256. Composition.section:vitalSigns.focus
                  Definition

                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                  ShortWho/what the section is about, when it is not about the subject of composition
                  Comments

                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                  Control0..1
                  TypeReference(Resource)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  258. Composition.section:vitalSigns.text
                  Definition

                  A human-readable narrative that contains the attested content of the section, 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.

                  ShortText summary of the section, for human interpretation
                  Comments

                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                  Control0..1
                  This element is affected by the following invariants: cmp-1
                  TypeNarrative
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  260. Composition.section:vitalSigns.mode
                  Definition

                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                  Shortworking | snapshot | changes
                  Comments

                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                  Control0..1
                  BindingThe codes SHALL be taken from ListMode
                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                  The processing mode that applies to this section.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                  Fixed Valuesnapshot
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  262. Composition.section:vitalSigns.orderedBy
                  Definition

                  Specifies the order applied to the items in the section entries.

                  ShortOrder of section entries
                  Comments

                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                  Control0..1
                  BindingThe codes SHOULD be taken from ListOrderCodes
                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                  What order applies to the items in the entry.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  264. Composition.section:vitalSigns.entry
                  Definition

                  A reference to the actual resource from which the narrative in the section is derived.

                  ShortA reference to data that supports this section
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..*
                  This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
                  TypeReference(http://hl7.org.au/fhir/core/StructureDefinition/au-core-vitalspanel, AU Core Blood Pressure, AU Core Body Weight, AU Core Body Height, http://hl7.org.au/fhir/core/StructureDefinition/au-core-bmi, http://hl7.org.au/fhir/core/StructureDefinition/au-core-oxygensat, http://hl7.org.au/fhir/core/StructureDefinition/au-core-headcircum, AU Core Heart Rate, AU Core Body Temperature, AU Core Respiration Rate)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  266. Composition.section:vitalSigns.entry.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  268. Composition.section:vitalSigns.entry.extension
                  Definition

                  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.

                  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())
                  SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 270. Composition.section:vitalSigns.entry.reference
                    Definition

                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                    ShortLiteral reference, Relative, internal or absolute URL
                    Comments

                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                    Control1..1
                    This element is affected by the following invariants: ref-1
                    Typestring
                    Is Modifierfalse
                    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()))
                    272. Composition.section:vitalSigns.entry.type
                    Definition

                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                    ShortType the reference refers to (e.g. "Patient")
                    Comments

                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                    Aa resource (or, for logical models, the URI of the logical model).

                    Typeuri
                    Is Modifierfalse
                    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()))
                    274. Composition.section:vitalSigns.entry.identifier
                    Definition

                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                    ShortLogical reference, when literal reference is not known
                    Comments

                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    TypeIdentifier
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    276. Composition.section:vitalSigns.entry.display
                    Definition

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    ShortText alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    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()))
                    278. Composition.section:vitalSigns.emptyReason
                    Definition

                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                    ShortWhy the section is empty
                    Comments

                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                    Control0..1
                    This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    280. Composition.section:vitalSigns.section
                    Definition

                    A nested sub-section within this section.

                    ShortNested Section
                    Comments

                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                    Control0..*
                    This element is affected by the following invariants: cmp-1
                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    282. Composition.section:medicines
                    Slice Namemedicines
                    Definition

                    A description of a patient's medicine use at a point in time. The list may be partial, or complete, and may be a history or scoped to may be taking the medication now or has taken the medication in the past or will be taking the medication in the future.

                    ShortMedicines
                    Control0..1
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    inv-dh-cocs-04: At most one assertion of no relevant finding shall be present and it shall assert no known current medications (entry.resolve().where($this is Observation).exists() implies (entry.count() < 2 and (entry.resolve().valueCodeableConcept.coding.code) = '1200661000168107'))
                    inv-dh-cocs-05: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
                    284. Composition.section:medicines.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    286. Composition.section:medicines.extension
                    Definition

                    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.

                    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())
                    288. Composition.section:medicines.modifierExtension
                    Definition

                    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).

                    ShortExtensions that cannot be ignored even if unrecognized
                    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 element that contains them
                    Summarytrue
                    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, modifiers
                    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())
                    290. Composition.section:medicines.title
                    Definition

                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                    ShortLabel for section (e.g. for ToC)
                    Comments

                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                    Alternate Namesheader, label, caption
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    292. Composition.section:medicines.code
                    Definition

                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                    ShortClassification of section (recommended)
                    Comments

                    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                    The LOINC concept 10160-0 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

                    The use of concept 101.16146 or 101.16022 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                    Control1..1
                    BindingFor example codes, see DocumentSectionCodes
                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                    Classification of a section of a composition/document.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Provides computable standardized labels to topics within the document.

                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "10160-0"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    294. Composition.section:medicines.author
                    Definition

                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                    ShortWho and/or what authored the section
                    Control0..*
                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Identifies who is responsible for the content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    296. Composition.section:medicines.focus
                    Definition

                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                    ShortWho/what the section is about, when it is not about the subject of composition
                    Comments

                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                    Control0..1
                    TypeReference(Resource)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    298. Composition.section:medicines.text
                    Definition

                    A human-readable narrative that contains the attested content of the section, 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.

                    ShortText summary of the section, for human interpretation
                    Comments

                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                    Control0..1
                    This element is affected by the following invariants: cmp-1
                    TypeNarrative
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    300. Composition.section:medicines.mode
                    Definition

                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                    Shortworking | snapshot | changes
                    Comments

                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                    Control0..1
                    BindingThe codes SHALL be taken from ListMode
                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                    The processing mode that applies to this section.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                    Fixed Valuesnapshot
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    302. Composition.section:medicines.orderedBy
                    Definition

                    Specifies the order applied to the items in the section entries.

                    ShortOrder of section entries
                    Comments

                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                    Control0..1
                    BindingThe codes SHOULD be taken from ListOrderCodes
                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                    What order applies to the items in the entry.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    304. Composition.section:medicines.entry
                    Definition

                    A reference to the actual resource from which the narrative in the section is derived.

                    ShortA reference to data that supports this section
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..*
                    This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-04, inv-dh-cocs-05
                    TypeReference(ADHA Medication Use List, ADHA Core MedicationStatement, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    306. Composition.section:medicines.entry.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    308. Composition.section:medicines.entry.extension
                    Definition

                    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.

                    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())
                    SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 310. Composition.section:medicines.entry.reference
                      Definition

                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                      ShortLiteral reference, Relative, internal or absolute URL
                      Comments

                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                      Control1..1
                      This element is affected by the following invariants: ref-1
                      Typestring
                      Is Modifierfalse
                      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()))
                      312. Composition.section:medicines.entry.type
                      Definition

                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                      ShortType the reference refers to (e.g. "Patient")
                      Comments

                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                      Aa resource (or, for logical models, the URI of the logical model).

                      Typeuri
                      Is Modifierfalse
                      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()))
                      314. Composition.section:medicines.entry.identifier
                      Definition

                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                      ShortLogical reference, when literal reference is not known
                      Comments

                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      316. Composition.section:medicines.entry.display
                      Definition

                      Plain text narrative that identifies the resource in addition to the resource reference.

                      ShortText alternative for the resource
                      Comments

                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      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()))
                      318. Composition.section:medicines.emptyReason
                      Definition

                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                      ShortWhy the section is empty
                      Comments

                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                      Control0..1
                      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                      BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      320. Composition.section:medicines.section
                      Definition

                      A nested sub-section within this section.

                      ShortNested Section
                      Comments

                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                      Control0..*
                      This element is affected by the following invariants: cmp-1
                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      322. Composition.section:immunisations
                      Slice Nameimmunisations
                      Definition

                      Information about the immunisation history, i.e. administered vaccines, of a patient.

                      ShortImmunisations
                      Control0..1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      inv-dh-cocs-08: At most one assertion of no relevant finding shall be present and it shall assert no history of vaccination (entry.resolve().where($this is Observation).exists() implies (entry.count() < 2 and (entry.resolve().valueCodeableConcept.coding.code) = '1234401000168109'))
                      inv-dh-cocs-09: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
                      324. Composition.section:immunisations.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      326. Composition.section:immunisations.extension
                      Definition

                      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.

                      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())
                      328. Composition.section:immunisations.modifierExtension
                      Definition

                      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).

                      ShortExtensions that cannot be ignored even if unrecognized
                      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 element that contains them
                      Summarytrue
                      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, modifiers
                      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())
                      330. Composition.section:immunisations.title
                      Definition

                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                      ShortLabel for section (e.g. for ToC)
                      Comments

                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                      Control1..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                      Alternate Namesheader, label, caption
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      332. Composition.section:immunisations.code
                      Definition

                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                      ShortClassification of section (recommended)
                      Comments

                      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                      The LOINC concept 11369-6 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                      The use of concept 101.16638 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                      Control1..1
                      BindingFor example codes, see DocumentSectionCodes
                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                      Classification of a section of a composition/document.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Provides computable standardized labels to topics within the document.

                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "11369-6"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      334. Composition.section:immunisations.author
                      Definition

                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                      ShortWho and/or what authored the section
                      Control0..*
                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                      Is Modifierfalse
                      Summaryfalse
                      Requirements

                      Identifies who is responsible for the content.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      336. Composition.section:immunisations.focus
                      Definition

                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                      ShortWho/what the section is about, when it is not about the subject of composition
                      Comments

                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                      Control0..1
                      TypeReference(Resource)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      338. Composition.section:immunisations.text
                      Definition

                      A human-readable narrative that contains the attested content of the section, 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.

                      ShortText summary of the section, for human interpretation
                      Comments

                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                      Control0..1
                      This element is affected by the following invariants: cmp-1
                      TypeNarrative
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      340. Composition.section:immunisations.mode
                      Definition

                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                      Shortworking | snapshot | changes
                      Comments

                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                      Control0..1
                      BindingThe codes SHALL be taken from ListMode
                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                      The processing mode that applies to this section.

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Requirements

                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                      Fixed Valuesnapshot
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      342. Composition.section:immunisations.orderedBy
                      Definition

                      Specifies the order applied to the items in the section entries.

                      ShortOrder of section entries
                      Comments

                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                      Control0..1
                      BindingThe codes SHOULD be taken from ListOrderCodes
                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                      What order applies to the items in the entry.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summaryfalse
                      Requirements

                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      344. Composition.section:immunisations.entry
                      Definition

                      A reference to the actual resource from which the narrative in the section is derived.

                      ShortA reference to data that supports this section
                      Comments

                      If there are no entries in the list, an emptyReason SHOULD be provided.

                      Control0..*
                      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-08, inv-dh-cocs-09
                      TypeReference(ADHA Immunisation History List, ADHA Core Immunization, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding)
                      Is Modifierfalse
                      Must Supporttrue
                      Must Support TypesNo must-support rules about the choice of types/profiles
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      346. Composition.section:immunisations.entry.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      348. Composition.section:immunisations.entry.extension
                      Definition

                      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.

                      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())
                      SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 350. Composition.section:immunisations.entry.reference
                        Definition

                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                        ShortLiteral reference, Relative, internal or absolute URL
                        Comments

                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                        Control1..1
                        This element is affected by the following invariants: ref-1
                        Typestring
                        Is Modifierfalse
                        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()))
                        352. Composition.section:immunisations.entry.type
                        Definition

                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                        ShortType the reference refers to (e.g. "Patient")
                        Comments

                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                        Aa resource (or, for logical models, the URI of the logical model).

                        Typeuri
                        Is Modifierfalse
                        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()))
                        354. Composition.section:immunisations.entry.identifier
                        Definition

                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                        ShortLogical reference, when literal reference is not known
                        Comments

                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1
                        TypeIdentifier
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        356. Composition.section:immunisations.entry.display
                        Definition

                        Plain text narrative that identifies the resource in addition to the resource reference.

                        ShortText alternative for the resource
                        Comments

                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        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()))
                        358. Composition.section:immunisations.emptyReason
                        Definition

                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                        ShortWhy the section is empty
                        Comments

                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                        Control0..1
                        This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                        BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                        (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        360. Composition.section:immunisations.section
                        Definition

                        A nested sub-section within this section.

                        ShortNested Section
                        Comments

                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                        Control0..*
                        This element is affected by the following invariants: cmp-1
                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        362. Composition.section:problems
                        Slice Nameproblems
                        Definition

                        Information about the clinical problems or conditions currently being monitored for a patient.

                        ShortProblems or Diagnoses
                        Comments

                        The inclusion of a problems section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR.

                        The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

                        Control0..1
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        inv-dh-cocs-07: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
                        364. Composition.section:problems.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        366. Composition.section:problems.extension
                        Definition

                        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.

                        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())
                        368. Composition.section:problems.modifierExtension
                        Definition

                        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).

                        ShortExtensions that cannot be ignored even if unrecognized
                        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 element that contains them
                        Summarytrue
                        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, modifiers
                        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())
                        370. Composition.section:problems.title
                        Definition

                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                        ShortLabel for section (e.g. for ToC)
                        Comments

                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                        Alternate Namesheader, label, caption
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        372. Composition.section:problems.code
                        Definition

                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                        ShortClassification of section (recommended)
                        Comments

                        The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                        The LOINC concept 11450-4 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                        The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                        Control1..1
                        BindingFor example codes, see DocumentSectionCodes
                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                        Classification of a section of a composition/document.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Provides computable standardized labels to topics within the document.

                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "11450-4"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        374. Composition.section:problems.author
                        Definition

                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                        ShortWho and/or what authored the section
                        Control0..*
                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Identifies who is responsible for the content.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        376. Composition.section:problems.focus
                        Definition

                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                        ShortWho/what the section is about, when it is not about the subject of composition
                        Comments

                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                        Control0..1
                        TypeReference(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        378. Composition.section:problems.text
                        Definition

                        A human-readable narrative that contains the attested content of the section, 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.

                        ShortText summary of the section, for human interpretation
                        Comments

                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                        Control0..1
                        This element is affected by the following invariants: cmp-1
                        TypeNarrative
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        380. Composition.section:problems.mode
                        Definition

                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                        Shortworking | snapshot | changes
                        Comments

                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                        Control0..1
                        BindingThe codes SHALL be taken from ListMode
                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                        The processing mode that applies to this section.

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Requirements

                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                        Fixed Valuesnapshot
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        382. Composition.section:problems.orderedBy
                        Definition

                        Specifies the order applied to the items in the section entries.

                        ShortOrder of section entries
                        Comments

                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                        Control0..1
                        BindingThe codes SHOULD be taken from ListOrderCodes
                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                        What order applies to the items in the entry.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        384. Composition.section:problems.entry
                        Definition

                        A reference to the actual resource from which the narrative in the section is derived.

                        ShortA reference to data that supports this section
                        Comments

                        If there are no entries in the list, an emptyReason SHOULD be provided.

                        Control0..*
                        This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-07
                        TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-condition-1, ADHA Core Condition)
                        Is Modifierfalse
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        386. Composition.section:problems.entry.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        388. Composition.section:problems.entry.extension
                        Definition

                        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.

                        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())
                        SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 390. Composition.section:problems.entry.reference
                          Definition

                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                          ShortLiteral reference, Relative, internal or absolute URL
                          Comments

                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                          Control1..1
                          This element is affected by the following invariants: ref-1
                          Typestring
                          Is Modifierfalse
                          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()))
                          392. Composition.section:problems.entry.type
                          Definition

                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                          ShortType the reference refers to (e.g. "Patient")
                          Comments

                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                          Aa resource (or, for logical models, the URI of the logical model).

                          Typeuri
                          Is Modifierfalse
                          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()))
                          394. Composition.section:problems.entry.identifier
                          Definition

                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                          ShortLogical reference, when literal reference is not known
                          Comments

                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          396. Composition.section:problems.entry.display
                          Definition

                          Plain text narrative that identifies the resource in addition to the resource reference.

                          ShortText alternative for the resource
                          Comments

                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          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()))
                          398. Composition.section:problems.emptyReason
                          Definition

                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                          ShortWhy the section is empty
                          Comments

                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                          Control0..1
                          This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                          BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                          (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          400. Composition.section:problems.section
                          Definition

                          A nested sub-section within this section.

                          ShortNested Section
                          Comments

                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                          Control0..*
                          This element is affected by the following invariants: cmp-1
                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          402. Composition.section:pastMedicalHistory
                          Slice NamepastMedicalHistory
                          Definition

                          Information about the history of past illness for a patient including the history related to their current complaints, problems, or diagnoses.

                          ShortPast medical history
                          Comments

                          The inclusion of a past medical history section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR, and National guidelines for on-screen presentation of discharge summaries' published by the Australian Commission on Safety and Quality in Health Care in August 2016.

                          The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

                          Control0..1
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          inv-dh-cocs-03: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
                          404. Composition.section:pastMedicalHistory.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          406. Composition.section:pastMedicalHistory.extension
                          Definition

                          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.

                          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())
                          408. Composition.section:pastMedicalHistory.modifierExtension
                          Definition

                          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).

                          ShortExtensions that cannot be ignored even if unrecognized
                          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 element that contains them
                          Summarytrue
                          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, modifiers
                          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())
                          410. Composition.section:pastMedicalHistory.title
                          Definition

                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                          ShortLabel for section (e.g. for ToC)
                          Comments

                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                          Alternate Namesheader, label, caption
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          412. Composition.section:pastMedicalHistory.code
                          Definition

                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                          ShortClassification of section (recommended)
                          Comments

                          The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                          The LOINC concept 11348-0 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                          The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                          Control1..1
                          BindingFor example codes, see DocumentSectionCodes
                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                          Classification of a section of a composition/document.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Provides computable standardized labels to topics within the document.

                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "11348-0"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          414. Composition.section:pastMedicalHistory.author
                          Definition

                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                          ShortWho and/or what authored the section
                          Control0..*
                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Identifies who is responsible for the content.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          416. Composition.section:pastMedicalHistory.focus
                          Definition

                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                          ShortWho/what the section is about, when it is not about the subject of composition
                          Comments

                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                          Control0..1
                          TypeReference(Resource)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          418. Composition.section:pastMedicalHistory.text
                          Definition

                          A human-readable narrative that contains the attested content of the section, 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.

                          ShortText summary of the section, for human interpretation
                          Comments

                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                          Control0..1
                          This element is affected by the following invariants: cmp-1
                          TypeNarrative
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          420. Composition.section:pastMedicalHistory.mode
                          Definition

                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                          Shortworking | snapshot | changes
                          Comments

                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                          Control0..1
                          BindingThe codes SHALL be taken from ListMode
                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                          The processing mode that applies to this section.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                          Fixed Valuesnapshot
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          422. Composition.section:pastMedicalHistory.orderedBy
                          Definition

                          Specifies the order applied to the items in the section entries.

                          ShortOrder of section entries
                          Comments

                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                          Control0..1
                          BindingThe codes SHOULD be taken from ListOrderCodes
                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                          What order applies to the items in the entry.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          424. Composition.section:pastMedicalHistory.entry
                          Definition

                          A reference to the actual resource from which the narrative in the section is derived.

                          ShortA reference to data that supports this section
                          Comments

                          If there are no entries in the list, an emptyReason SHOULD be provided.

                          Control0..*
                          This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-03
                          TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-condition-1, ADHA Core Condition)
                          Is Modifierfalse
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          426. Composition.section:pastMedicalHistory.entry.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          428. Composition.section:pastMedicalHistory.entry.extension
                          Definition

                          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.

                          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())
                          SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 430. Composition.section:pastMedicalHistory.entry.reference
                            Definition

                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                            ShortLiteral reference, Relative, internal or absolute URL
                            Comments

                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                            Control1..1
                            This element is affected by the following invariants: ref-1
                            Typestring
                            Is Modifierfalse
                            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()))
                            432. Composition.section:pastMedicalHistory.entry.type
                            Definition

                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                            ShortType the reference refers to (e.g. "Patient")
                            Comments

                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                            Aa resource (or, for logical models, the URI of the logical model).

                            Typeuri
                            Is Modifierfalse
                            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()))
                            434. Composition.section:pastMedicalHistory.entry.identifier
                            Definition

                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                            ShortLogical reference, when literal reference is not known
                            Comments

                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            436. Composition.section:pastMedicalHistory.entry.display
                            Definition

                            Plain text narrative that identifies the resource in addition to the resource reference.

                            ShortText alternative for the resource
                            Comments

                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            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()))
                            438. Composition.section:pastMedicalHistory.emptyReason
                            Definition

                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                            ShortWhy the section is empty
                            Comments

                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                            Control0..1
                            This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                            BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                            (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            440. Composition.section:pastMedicalHistory.section
                            Definition

                            A nested sub-section within this section.

                            ShortNested Section
                            Comments

                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                            Control0..*
                            This element is affected by the following invariants: cmp-1
                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            442. Composition.section:procedures
                            Slice Nameprocedures
                            Definition

                            Information about the clinical problems or conditions currently being monitored for a patient.

                            ShortProcedures
                            Comments

                            The inclusion of a problems section adopted is in line with the section grouping in the International Patient Summary (IPS), Consolidated CDA (C-CDA), C-CDA on FHIR, and National guidelines for on-screen presentation of discharge summaries' published by the Australian Commission on Safety and Quality in Health Care in August 2016.

                            The use of a single grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

                            Control0..1
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            inv-dh-cocs-06: At most one list shall be present (entry.resolve().where($this is List).exists() implies entry.count() < 2)
                            444. Composition.section:procedures.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            446. Composition.section:procedures.extension
                            Definition

                            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.

                            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())
                            448. Composition.section:procedures.modifierExtension
                            Definition

                            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).

                            ShortExtensions that cannot be ignored even if unrecognized
                            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 element that contains them
                            Summarytrue
                            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, modifiers
                            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())
                            450. Composition.section:procedures.title
                            Definition

                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                            ShortLabel for section (e.g. for ToC)
                            Comments

                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                            Alternate Namesheader, label, caption
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            452. Composition.section:procedures.code
                            Definition

                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                            ShortClassification of section (recommended)
                            Comments

                            The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                            The LOINC concept 47519-4 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                            The use of a grouping Medical History section with concept 101.16117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may be present in older data.

                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                            Control1..1
                            BindingFor example codes, see DocumentSectionCodes
                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                            Classification of a section of a composition/document.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Provides computable standardized labels to topics within the document.

                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "47519-4"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            454. Composition.section:procedures.author
                            Definition

                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                            ShortWho and/or what authored the section
                            Control0..*
                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Identifies who is responsible for the content.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            456. Composition.section:procedures.focus
                            Definition

                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                            ShortWho/what the section is about, when it is not about the subject of composition
                            Comments

                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                            Control0..1
                            TypeReference(Resource)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            458. Composition.section:procedures.text
                            Definition

                            A human-readable narrative that contains the attested content of the section, 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.

                            ShortText summary of the section, for human interpretation
                            Comments

                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                            Control0..1
                            This element is affected by the following invariants: cmp-1
                            TypeNarrative
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            460. Composition.section:procedures.mode
                            Definition

                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                            Shortworking | snapshot | changes
                            Comments

                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                            Control0..1
                            BindingThe codes SHALL be taken from ListMode
                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                            The processing mode that applies to this section.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Requirements

                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                            Fixed Valuesnapshot
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            462. Composition.section:procedures.orderedBy
                            Definition

                            Specifies the order applied to the items in the section entries.

                            ShortOrder of section entries
                            Comments

                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                            Control0..1
                            BindingThe codes SHOULD be taken from ListOrderCodes
                            (preferred to http://hl7.org/fhir/ValueSet/list-order)

                            What order applies to the items in the entry.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            464. Composition.section:procedures.entry
                            Definition

                            A reference to the actual resource from which the narrative in the section is derived.

                            ShortA reference to data that supports this section
                            Comments

                            If there are no entries in the list, an emptyReason SHOULD be provided.

                            Control0..*
                            This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-06
                            TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-list-procedure-1, ADHA Core Procedure)
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            466. Composition.section:procedures.entry.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            468. Composition.section:procedures.entry.extension
                            Definition

                            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.

                            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())
                            SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 470. Composition.section:procedures.entry.reference
                              Definition

                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                              ShortLiteral reference, Relative, internal or absolute URL
                              Comments

                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                              Control1..1
                              This element is affected by the following invariants: ref-1
                              Typestring
                              Is Modifierfalse
                              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()))
                              472. Composition.section:procedures.entry.type
                              Definition

                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                              ShortType the reference refers to (e.g. "Patient")
                              Comments

                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                              Aa resource (or, for logical models, the URI of the logical model).

                              Typeuri
                              Is Modifierfalse
                              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()))
                              474. Composition.section:procedures.entry.identifier
                              Definition

                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                              ShortLogical reference, when literal reference is not known
                              Comments

                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..1
                              TypeIdentifier
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              476. Composition.section:procedures.entry.display
                              Definition

                              Plain text narrative that identifies the resource in addition to the resource reference.

                              ShortText alternative for the resource
                              Comments

                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              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()))
                              478. Composition.section:procedures.emptyReason
                              Definition

                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                              ShortWhy the section is empty
                              Comments

                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                              Control0..1
                              This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                              BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                              (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              480. Composition.section:procedures.section
                              Definition

                              A nested sub-section within this section.

                              ShortNested Section
                              Comments

                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                              Control0..*
                              This element is affected by the following invariants: cmp-1
                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              482. Composition.section:functionalStatus
                              Slice NamefunctionalStatus
                              Definition

                              Information about the patient's status of normal functioning at the time the record was created. Functional statuses include information regarding the patient relative to ambulatory ability, mental status or competency, activities of daily living (ADLs) (i.e. bathing, dressing, feeding, grooming), home/living situation having an effect on the health status of the patient, ability to care for self, social activity (i.e. issues with social cognition, participation with friends and acquaintances other than family members), occupation activity (i.e. activities partly or directly related to working), housework or volunteering, family and home responsibilities or activities related to home and family, communication ability (i.e. issues with speech, writing or cognition required for communication), and perception, including sight, hearing, taste, skin sensation, kinesthetic sense, proprioception, or balance.

                              ShortFunctional Status
                              Control0..1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              484. Composition.section:functionalStatus.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              486. Composition.section:functionalStatus.extension
                              Definition

                              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.

                              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())
                              488. Composition.section:functionalStatus.modifierExtension
                              Definition

                              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).

                              ShortExtensions that cannot be ignored even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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, modifiers
                              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())
                              490. Composition.section:functionalStatus.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShortLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control1..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              492. Composition.section:functionalStatus.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                              The LOINC concept 46264-8 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control1..1
                              BindingFor example codes, see DocumentSectionCodes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "46264-8"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              494. Composition.section:functionalStatus.author
                              Definition

                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                              ShortWho and/or what authored the section
                              Control0..*
                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Identifies who is responsible for the content.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              496. Composition.section:functionalStatus.focus
                              Definition

                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                              ShortWho/what the section is about, when it is not about the subject of composition
                              Comments

                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                              Control0..1
                              TypeReference(Resource)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              498. Composition.section:functionalStatus.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control0..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              500. Composition.section:functionalStatus.mode
                              Definition

                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                              Shortworking | snapshot | changes
                              Comments

                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                              Control0..1
                              BindingThe codes SHALL be taken from ListMode
                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                              The processing mode that applies to this section.

                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                              Fixed Valuesnapshot
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              502. Composition.section:functionalStatus.orderedBy
                              Definition

                              Specifies the order applied to the items in the section entries.

                              ShortOrder of section entries
                              Comments

                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                              Control0..1
                              BindingThe codes SHOULD be taken from ListOrderCodes
                              (preferred to http://hl7.org/fhir/ValueSet/list-order)

                              What order applies to the items in the entry.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              504. Composition.section:functionalStatus.entry
                              Definition

                              A reference to the actual resource from which the narrative in the section is derived.

                              ShortA reference to data that supports this section
                              Comments

                              If there are no entries in the list, an emptyReason SHOULD be provided.

                              Control0..*
                              This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-10
                              TypeReference(ADHA Core Observation, ADHA Core Condition)
                              Is Modifierfalse
                              Must Supporttrue
                              Must Support TypesNo must-support rules about the choice of types/profiles
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              506. Composition.section:functionalStatus.entry.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              508. Composition.section:functionalStatus.entry.extension
                              Definition

                              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.

                              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())
                              SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 510. Composition.section:functionalStatus.entry.reference
                                Definition

                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                ShortLiteral reference, Relative, internal or absolute URL
                                Comments

                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                Control1..1
                                This element is affected by the following invariants: ref-1
                                Typestring
                                Is Modifierfalse
                                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()))
                                512. Composition.section:functionalStatus.entry.type
                                Definition

                                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                ShortType the reference refers to (e.g. "Patient")
                                Comments

                                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                Control0..1
                                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                Aa resource (or, for logical models, the URI of the logical model).

                                Typeuri
                                Is Modifierfalse
                                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()))
                                514. Composition.section:functionalStatus.entry.identifier
                                Definition

                                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                ShortLogical reference, when literal reference is not known
                                Comments

                                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control0..1
                                TypeIdentifier
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                516. Composition.section:functionalStatus.entry.display
                                Definition

                                Plain text narrative that identifies the resource in addition to the resource reference.

                                ShortText alternative for the resource
                                Comments

                                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                Control0..1
                                Typestring
                                Is Modifierfalse
                                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()))
                                518. Composition.section:functionalStatus.emptyReason
                                Definition

                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                ShortWhy the section is empty
                                Comments

                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                Control0..1
                                This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                                BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                                (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                520. Composition.section:functionalStatus.section
                                Definition

                                A nested sub-section within this section.

                                ShortNested Section
                                Comments

                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                Control0..*
                                This element is affected by the following invariants: cmp-1
                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                522. Composition.section:familyHistory
                                Slice NamefamilyHistory
                                Definition

                                Information about the family history of a patient.

                                ShortFamily History
                                Control0..1
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                524. Composition.section:familyHistory.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                526. Composition.section:familyHistory.extension
                                Definition

                                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.

                                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())
                                528. Composition.section:familyHistory.modifierExtension
                                Definition

                                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).

                                ShortExtensions that cannot be ignored even if unrecognized
                                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 element that contains them
                                Summarytrue
                                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, modifiers
                                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())
                                530. Composition.section:familyHistory.title
                                Definition

                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                ShortLabel for section (e.g. for ToC)
                                Comments

                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                Control1..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                Alternate Namesheader, label, caption
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                532. Composition.section:familyHistory.code
                                Definition

                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                ShortClassification of section (recommended)
                                Comments

                                The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                                The LOINC concept 10157-6 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                Control1..1
                                BindingFor example codes, see DocumentSectionCodes
                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                Classification of a section of a composition/document.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Provides computable standardized labels to topics within the document.

                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "10157-6"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                534. Composition.section:familyHistory.author
                                Definition

                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                ShortWho and/or what authored the section
                                Control0..*
                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Identifies who is responsible for the content.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                536. Composition.section:familyHistory.focus
                                Definition

                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                ShortWho/what the section is about, when it is not about the subject of composition
                                Comments

                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                Control0..1
                                TypeReference(Resource)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                538. Composition.section:familyHistory.text
                                Definition

                                A human-readable narrative that contains the attested content of the section, 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.

                                ShortText summary of the section, for human interpretation
                                Comments

                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                Control0..1
                                This element is affected by the following invariants: cmp-1
                                TypeNarrative
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                540. Composition.section:familyHistory.mode
                                Definition

                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                Shortworking | snapshot | changes
                                Comments

                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                Control0..1
                                BindingThe codes SHALL be taken from ListMode
                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                The processing mode that applies to this section.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                Fixed Valuesnapshot
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                542. Composition.section:familyHistory.orderedBy
                                Definition

                                Specifies the order applied to the items in the section entries.

                                ShortOrder of section entries
                                Comments

                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                Control0..1
                                BindingThe codes SHOULD be taken from ListOrderCodes
                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                What order applies to the items in the entry.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                544. Composition.section:familyHistory.entry
                                Definition

                                A reference to the actual resource from which the narrative in the section is derived.

                                ShortA reference to data that supports this section
                                Comments

                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                Control0..*
                                This element is affected by the following invariants: cmp-2
                                TypeReference(http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-familyhistory-core-1)
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                546. Composition.section:familyHistory.entry.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                548. Composition.section:familyHistory.entry.extension
                                Definition

                                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.

                                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())
                                SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 550. Composition.section:familyHistory.entry.reference
                                  Definition

                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                  ShortLiteral reference, Relative, internal or absolute URL
                                  Comments

                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                  Control1..1
                                  This element is affected by the following invariants: ref-1
                                  Typestring
                                  Is Modifierfalse
                                  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()))
                                  552. Composition.section:familyHistory.entry.type
                                  Definition

                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                  ShortType the reference refers to (e.g. "Patient")
                                  Comments

                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                  Control0..1
                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                  Aa resource (or, for logical models, the URI of the logical model).

                                  Typeuri
                                  Is Modifierfalse
                                  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()))
                                  554. Composition.section:familyHistory.entry.identifier
                                  Definition

                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                  ShortLogical reference, when literal reference is not known
                                  Comments

                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..1
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  556. Composition.section:familyHistory.entry.display
                                  Definition

                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                  ShortText alternative for the resource
                                  Comments

                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  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()))
                                  558. Composition.section:familyHistory.emptyReason
                                  Definition

                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                  ShortWhy the section is empty
                                  Comments

                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                  Control0..1
                                  This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                                  BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                                  (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  560. Composition.section:familyHistory.section
                                  Definition

                                  A nested sub-section within this section.

                                  ShortNested Section
                                  Comments

                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                  Control0..*
                                  This element is affected by the following invariants: cmp-1
                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  562. Composition.section:socialHistory
                                  Slice NamesocialHistory
                                  Definition

                                  Information about a patient's health related lifestyle factors or lifestyle observations (e.g. smoke habits; alcohol consumption; diets, risky habits.).

                                  ShortSocial History (Lifestyle factors)
                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  564. Composition.section:socialHistory.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  566. Composition.section:socialHistory.extension
                                  Definition

                                  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.

                                  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())
                                  568. Composition.section:socialHistory.modifierExtension
                                  Definition

                                  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).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  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 element that contains them
                                  Summarytrue
                                  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, modifiers
                                  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())
                                  570. Composition.section:socialHistory.title
                                  Definition

                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                  ShortLabel for section (e.g. for ToC)
                                  Comments

                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                  Control1..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                  Alternate Namesheader, label, caption
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  572. Composition.section:socialHistory.code
                                  Definition

                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                  ShortClassification of section (recommended)
                                  Comments

                                  The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                                  The LOINC concept 29762-2 adopted for this section is aligned with the vocabulary in Consolidated CDA (C-CDA) and C-CDA on FHIR.

                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                  Control1..1
                                  BindingFor example codes, see DocumentSectionCodes
                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                  Classification of a section of a composition/document.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Provides computable standardized labels to topics within the document.

                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "29762-2"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  574. Composition.section:socialHistory.author
                                  Definition

                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                  ShortWho and/or what authored the section
                                  Control0..*
                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Identifies who is responsible for the content.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  576. Composition.section:socialHistory.focus
                                  Definition

                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                  ShortWho/what the section is about, when it is not about the subject of composition
                                  Comments

                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                  Control0..1
                                  TypeReference(Resource)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  578. Composition.section:socialHistory.text
                                  Definition

                                  A human-readable narrative that contains the attested content of the section, 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.

                                  ShortText summary of the section, for human interpretation
                                  Comments

                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                  Control0..1
                                  This element is affected by the following invariants: cmp-1
                                  TypeNarrative
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  580. Composition.section:socialHistory.mode
                                  Definition

                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                  Shortworking | snapshot | changes
                                  Comments

                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                  Control0..1
                                  BindingThe codes SHALL be taken from ListMode
                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                  The processing mode that applies to this section.

                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Requirements

                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                  Fixed Valuesnapshot
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  582. Composition.section:socialHistory.orderedBy
                                  Definition

                                  Specifies the order applied to the items in the section entries.

                                  ShortOrder of section entries
                                  Comments

                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                  Control0..1
                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                  What order applies to the items in the entry.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  584. Composition.section:socialHistory.entry
                                  Definition

                                  A reference to the actual resource from which the narrative in the section is derived.

                                  ShortA reference to data that supports this section
                                  Comments

                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                  Control0..*
                                  This element is affected by the following invariants: cmp-2
                                  TypeReference(ADHA Core Observation, http://hl7.org.au/fhir/core/StructureDefinition/au-core-alcoholstatus, AU Core Smoking Status, http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingstartdate, http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingceasedate)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  586. Composition.section:socialHistory.entry.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  588. Composition.section:socialHistory.entry.extension
                                  Definition

                                  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.

                                  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())
                                  SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 590. Composition.section:socialHistory.entry.reference
                                    Definition

                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                    ShortLiteral reference, Relative, internal or absolute URL
                                    Comments

                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                    Control1..1
                                    This element is affected by the following invariants: ref-1
                                    Typestring
                                    Is Modifierfalse
                                    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()))
                                    592. Composition.section:socialHistory.entry.type
                                    Definition

                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                    ShortType the reference refers to (e.g. "Patient")
                                    Comments

                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                    Aa resource (or, for logical models, the URI of the logical model).

                                    Typeuri
                                    Is Modifierfalse
                                    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()))
                                    594. Composition.section:socialHistory.entry.identifier
                                    Definition

                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                    ShortLogical reference, when literal reference is not known
                                    Comments

                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control0..1
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    596. Composition.section:socialHistory.entry.display
                                    Definition

                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                    ShortText alternative for the resource
                                    Comments

                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    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()))
                                    598. Composition.section:socialHistory.emptyReason
                                    Definition

                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                    ShortWhy the section is empty
                                    Comments

                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                    Control0..1
                                    This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                                    BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                                    (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    600. Composition.section:socialHistory.section
                                    Definition

                                    A nested sub-section within this section.

                                    ShortNested Section
                                    Comments

                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                    Control0..*
                                    This element is affected by the following invariants: cmp-1
                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    602. Composition.section:medicalDevices
                                    Slice NamemedicalDevices
                                    Definition

                                    Information about the medical device (medical equipment) use defines a patient's implanted and external medical devices and equipment that their health status depends on, as well as any pertinent equipment or device history.

                                    ShortMedical devices
                                    Control0..1
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    inv-dh-cocs-10: At most one assertion of no relevant finding shall be present (entry.resolve().where($this is Observation).exists() implies entry.count() < 2)
                                    604. Composition.section:medicalDevices.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    606. Composition.section:medicalDevices.extension
                                    Definition

                                    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.

                                    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())
                                    608. Composition.section:medicalDevices.modifierExtension
                                    Definition

                                    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).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    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 element that contains them
                                    Summarytrue
                                    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, modifiers
                                    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())
                                    610. Composition.section:medicalDevices.title
                                    Definition

                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                    ShortLabel for section (e.g. for ToC)
                                    Comments

                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                    Control1..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                    Alternate Namesheader, label, caption
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    612. Composition.section:medicalDevices.code
                                    Definition

                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                    ShortClassification of section (recommended)
                                    Comments

                                    The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                                    The LOINC concept 46264-8 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                    Control1..1
                                    BindingFor example codes, see DocumentSectionCodes
                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                    Classification of a section of a composition/document.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Provides computable standardized labels to topics within the document.

                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "46264-8"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    614. Composition.section:medicalDevices.author
                                    Definition

                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                    ShortWho and/or what authored the section
                                    Control0..*
                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Identifies who is responsible for the content.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    616. Composition.section:medicalDevices.focus
                                    Definition

                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                    ShortWho/what the section is about, when it is not about the subject of composition
                                    Comments

                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                    Control0..1
                                    TypeReference(Resource)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    618. Composition.section:medicalDevices.text
                                    Definition

                                    A human-readable narrative that contains the attested content of the section, 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.

                                    ShortText summary of the section, for human interpretation
                                    Comments

                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                    Control0..1
                                    This element is affected by the following invariants: cmp-1
                                    TypeNarrative
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    620. Composition.section:medicalDevices.mode
                                    Definition

                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                    Shortworking | snapshot | changes
                                    Comments

                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                    Control0..1
                                    BindingThe codes SHALL be taken from ListMode
                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                    The processing mode that applies to this section.

                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    Requirements

                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                    Fixed Valuesnapshot
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    622. Composition.section:medicalDevices.orderedBy
                                    Definition

                                    Specifies the order applied to the items in the section entries.

                                    ShortOrder of section entries
                                    Comments

                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                    Control0..1
                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                    What order applies to the items in the entry.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    624. Composition.section:medicalDevices.entry
                                    Definition

                                    A reference to the actual resource from which the narrative in the section is derived.

                                    ShortA reference to data that supports this section
                                    Comments

                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                    Control0..*
                                    This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02, inv-dh-cocs-10
                                    TypeReference(ADHA Implantable Medical Device, http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-device-wearable-1, http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-deviceusestatement-core-1, http://hl7.org.au/fhir/core/StructureDefinition/au-core-norelevantfinding)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    626. Composition.section:medicalDevices.entry.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    628. Composition.section:medicalDevices.entry.extension
                                    Definition

                                    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.

                                    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())
                                    SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 630. Composition.section:medicalDevices.entry.reference
                                      Definition

                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                      ShortLiteral reference, Relative, internal or absolute URL
                                      Comments

                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                      Control1..1
                                      This element is affected by the following invariants: ref-1
                                      Typestring
                                      Is Modifierfalse
                                      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()))
                                      632. Composition.section:medicalDevices.entry.type
                                      Definition

                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                      ShortType the reference refers to (e.g. "Patient")
                                      Comments

                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                      Aa resource (or, for logical models, the URI of the logical model).

                                      Typeuri
                                      Is Modifierfalse
                                      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()))
                                      634. Composition.section:medicalDevices.entry.identifier
                                      Definition

                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                      ShortLogical reference, when literal reference is not known
                                      Comments

                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..1
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      636. Composition.section:medicalDevices.entry.display
                                      Definition

                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                      ShortText alternative for the resource
                                      Comments

                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      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()))
                                      638. Composition.section:medicalDevices.emptyReason
                                      Definition

                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                      ShortWhy the section is empty
                                      Comments

                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                      Control0..1
                                      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                                      BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                                      (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      640. Composition.section:medicalDevices.section
                                      Definition

                                      A nested sub-section within this section.

                                      ShortNested Section
                                      Comments

                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                      Control0..*
                                      This element is affected by the following invariants: cmp-1
                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      642. Composition.section:diagnosticInvestigations
                                      Slice NamediagnosticInvestigations
                                      Definition

                                      Information about diagnostic tests or procedures performed on or requested for an individual, that are considered relevant to the individual's ongoing care. This does not include a full list of diagnostic tests and procedures performed on or request for the individual but only those that are relevant to the encounter.

                                      ShortDiagnostic Investigations (Editorial Note: The design of this section is incomplete.
                                      Control0..1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      644. Composition.section:diagnosticInvestigations.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      646. Composition.section:diagnosticInvestigations.extension
                                      Definition

                                      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.

                                      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())
                                      648. Composition.section:diagnosticInvestigations.modifierExtension
                                      Definition

                                      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).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      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 element that contains them
                                      Summarytrue
                                      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, modifiers
                                      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())
                                      650. Composition.section:diagnosticInvestigations.title
                                      Definition

                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                      ShortLabel for section (e.g. for ToC)
                                      Comments

                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                      Control1..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                      Alternate Namesheader, label, caption
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      652. Composition.section:diagnosticInvestigations.code
                                      Definition

                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                      ShortClassification of section (recommended)
                                      Comments

                                      The code identifies the section for an automated processor of the document. When sharing health records it is important that globally adopted vocabulary is supported to allow for ubiquitous discovery, access, and re-use. To meet this need, where a consistent vocabulary and common syntax to achieve semantic interoperability is widely adopted internationally that code is adopted in Agency materials.

                                      The LOINC concept 30954-2 adopted for this section is aligned with the vocabulary in International Patient Summary (IPS), Consolidated CDA (C-CDA) and C-CDA on FHIR.

                                      The use of concept 101.20117 from the Agency's NCTIS (National Clinical Terminology and Information Service) Data Components code system is deprecated but may also be supplied as an additional coding or it may be present in older data.

                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                      Control1..1
                                      BindingFor example codes, see DocumentSectionCodes
                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                      Classification of a section of a composition/document.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Provides computable standardized labels to topics within the document.

                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "30954-2"
                                        }]
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      654. Composition.section:diagnosticInvestigations.author
                                      Definition

                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                      ShortWho and/or what authored the section
                                      Control0..*
                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Identifies who is responsible for the content.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      656. Composition.section:diagnosticInvestigations.focus
                                      Definition

                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                      ShortWho/what the section is about, when it is not about the subject of composition
                                      Comments

                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                      Control0..1
                                      TypeReference(Resource)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      658. Composition.section:diagnosticInvestigations.text
                                      Definition

                                      A human-readable narrative that contains the attested content of the section, 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.

                                      ShortText summary of the section, for human interpretation
                                      Comments

                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                      Control0..1
                                      This element is affected by the following invariants: cmp-1
                                      TypeNarrative
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      660. Composition.section:diagnosticInvestigations.mode
                                      Definition

                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                      Shortworking | snapshot | changes
                                      Comments

                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                      Control0..1
                                      BindingThe codes SHALL be taken from ListMode
                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                      The processing mode that applies to this section.

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                      Fixed Valuesnapshot
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      662. Composition.section:diagnosticInvestigations.orderedBy
                                      Definition

                                      Specifies the order applied to the items in the section entries.

                                      ShortOrder of section entries
                                      Comments

                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                      Control0..1
                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                      What order applies to the items in the entry.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      664. Composition.section:diagnosticInvestigations.entry
                                      Definition

                                      A reference to the actual resource from which the narrative in the section is derived.

                                      ShortDiagnostic investigations
                                      Comments

                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                      Control0..*
                                      This element is affected by the following invariants: cmp-2, inv-dh-cocs-01, inv-dh-cocs-02
                                      TypeReference(ADHA Core DiagnosticReport, ADHA Diagnostic Result Observation, ADHA Imaging Result Observation, ADHA Pathology Result Observation)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      666. Composition.section:diagnosticInvestigations.entry.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      668. Composition.section:diagnosticInvestigations.entry.extension
                                      Definition

                                      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.

                                      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())
                                      SlicingThis element introduces a set of slices on Composition.section.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 670. Composition.section:diagnosticInvestigations.entry.reference
                                        Definition

                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                        ShortLiteral reference, Relative, internal or absolute URL
                                        Comments

                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                        Control1..1
                                        This element is affected by the following invariants: ref-1
                                        Typestring
                                        Is Modifierfalse
                                        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()))
                                        672. Composition.section:diagnosticInvestigations.entry.type
                                        Definition

                                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                        ShortType the reference refers to (e.g. "Patient")
                                        Comments

                                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                        Control0..1
                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                        Aa resource (or, for logical models, the URI of the logical model).

                                        Typeuri
                                        Is Modifierfalse
                                        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()))
                                        674. Composition.section:diagnosticInvestigations.entry.identifier
                                        Definition

                                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                        ShortLogical reference, when literal reference is not known
                                        Comments

                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control0..1
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        676. Composition.section:diagnosticInvestigations.entry.display
                                        Definition

                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                        ShortText alternative for the resource
                                        Comments

                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        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()))
                                        678. Composition.section:diagnosticInvestigations.emptyReason
                                        Definition

                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                        ShortWhy the section is empty
                                        Comments

                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                        Control0..1
                                        This element is affected by the following invariants: cmp-2, inv-dh-cocs-01
                                        BindingThe codes SHALL be taken from Health Summary Non-Clinical Empty Reason .
                                        (required to https://healthterminologies.gov.au/fhir/ValueSet/health-summary-non-clinical-empty-reason-2)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        680. Composition.section:diagnosticInvestigations.section
                                        Definition

                                        A nested sub-section within this section.

                                        ShortNested Section
                                        Comments

                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                        Control0..*
                                        This element is affected by the following invariants: cmp-1
                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))