HL7 Czech Health information exchange Implementation Guide
0.0.1 - ci-build

HL7 Czech Health information exchange Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/HIE/ and changes regularly. See the Directory of published versions

## Resource Profile: CZ MHD DocumentReference Comprehensive

Official URL: https://hl7.cz/fhir/hie/StructureDefinition/cz-mhd-documentreference-comprehensive | Version: 0.0.1
Draft as of 2025-10-14 | Computable Name: CZ_MhdDocumentReferenceComprehensive

CZ MHD Profile on DocumentReference

Usages:

- Use this Profile: CZ MHD Find Document References Comprehensive Response message and CZ MHD Provide Document Bundle Comprehensive
- Refer to this Profile: CZ MHD SubmissionSet Comprehensive
- CapabilityStatements using this Profile: MHD Document Consumer (client) and MHD Document Responder (server)

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: cz-mhd
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 1..1 | code | Language of the resource content Binding: eHDSI Language (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 1..1 | UniqueIdIdentifier | Master Version Specific Identifier
status | ?!Σ | 1..1 | code | current | superseded Binding: DocumentReferenceStatus (required): The status of the document reference.
type | Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: CZ DocumentEntry TypeCode ValueSet (required)
category | Σ | 1..1 | CodeableConcept | Categorization of document Binding: CZ DocumentEntry ClassCode ValueSet (required)
subject | Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
identifier | Σ | 1..1 | CZ_RID_Identifier | Logical reference, when literal reference is not known
author | Σ | 0..* | Reference(Practitioner Role (CZ core)) {c} | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) {c} | Who/what authenticated the document
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
securityLabel | Σ | 1..* | CodeableConcept | Document security-tags Binding: V3 Value SetConfidentialityClassification (required)
content | Σ | 1..1 | BackboneElement | Document referenced
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
contentType | Σ | 1..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 1..1 | code | Human language of the content (BCP-47) Binding: eHDSI Language (required) Example General: en-AU
url | Σ | 1..1 | url | The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle. Example General: http://www.acme.com/logo-small.png
title | Σ | 1..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 1..1 | dateTime | Date attachment was first created
format | Σ | 1..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context | Σ | 1..1 | BackboneElement | Clinical context of document
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
facilityType |  | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 1..1 | Reference(Patient (CZ core)) {c} | Patient demographics from source
Slices for related |  | 0..* | Reference(Resource) | Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID |  | 0..1 | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | CZ DocumentEntry TypeCode ValueSet | 📦0.0.1 | This IG
DocumentReference.category | Base | required | CZ DocumentEntry ClassCode ValueSet | 📦0.0.1 | This IG
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | required | V3 Value SetConfidentialityClassification | 📦2014-03-26 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cz-mhd | error | DocumentReference | The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference | `conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | error | DocumentReference | 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 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DocumentReference

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: cz-mhd
language |  | 1..1 | code | Language of the resource content Binding: eHDSI Language (required)
masterIdentifier |  | 1..1 | UniqueIdIdentifier | Master Version Specific Identifier
status |  | 1..1 | code | current | superseded
docStatus |  | 0..0 |  |
type |  | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: CZ DocumentEntry TypeCode ValueSet (required)
category |  | 1..1 | CodeableConcept | Categorization of document Binding: CZ DocumentEntry ClassCode ValueSet (required)
subject |  | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
identifier |  | 1..1 | CZ_RID_Identifier | Logical reference, when literal reference is not known
author |  | 0..* | Reference(Practitioner Role (CZ core)) {c} | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) {c} | Who/what authenticated the document
custodian |  | 0..0 |  |
relatesTo |  | 0..* | BackboneElement | Relationships to other documents
securityLabel |  | 1..* | CodeableConcept | Document security-tags Binding: V3 Value SetConfidentialityClassification (required)
content |  | 1..1 | BackboneElement | Document referenced
attachment |  |  |  |
contentType |  | 1..1 | code | Mime type of the content, with charset etc.
language |  | 1..1 | code | Human language of the content (BCP-47) Binding: eHDSI Language (required)
data |  | 0..0 |  |
url |  | 1..1 | url | The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle.
title |  | 1..1 | string | Label to display in place of the data
creation |  | 1..1 | dateTime | Date attachment was first created
format |  | 1..1 | Coding | Format/content rules for the document
context |  | 1..1 | BackboneElement | Clinical context of document
facilityType |  | 1..1 | CodeableConcept | Kind of facility where patient was seen
practiceSetting |  | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty)
sourcePatientInfo |  | 1..1 | Reference(Patient (CZ core)) {c} | Patient demographics from source
Slices for related |  | 0..* | Reference(Resource) | Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID |  | 0..1 | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.type | Base | required | CZ DocumentEntry TypeCode ValueSet | 📦0.0.1 | This IG
DocumentReference.category | Base | required | CZ DocumentEntry ClassCode ValueSet | 📦0.0.1 | This IG
DocumentReference.securityLabel | Base | required | V3 Value SetConfidentialityClassification | 📦2014-03-26 | FHIR Std.
DocumentReference.content.​attachment.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu

#### Constraints

Id | Grade | Path(s) | Description | Expression
cz-mhd | error | DocumentReference | The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference | `conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: cz-mhd
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 1..1 | code | Language of the resource content Binding: eHDSI Language (required)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 1..1 | UniqueIdIdentifier | Master Version Specific Identifier
identifier | Σ | 0..* | Identifier | Other identifiers for the document
status | ?!Σ | 1..1 | code | current | superseded Binding: DocumentReferenceStatus (required): The status of the document reference.
type | Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: CZ DocumentEntry TypeCode ValueSet (required)
category | Σ | 1..1 | CodeableConcept | Categorization of document Binding: CZ DocumentEntry ClassCode ValueSet (required)
subject | Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 1..1 | CZ_RID_Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
date | Σ | 0..1 | instant | When this document reference was created
author | Σ | 0..* | Reference(Practitioner Role (CZ core)) {c} | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) {c} | Who/what authenticated the document
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
description | Σ | 0..1 | string | Human-readable description
securityLabel | Σ | 1..* | CodeableConcept | Document security-tags Binding: V3 Value SetConfidentialityClassification (required)
content | Σ | 1..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | Σ | 1..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 1..1 | code | Human language of the content (BCP-47) Binding: eHDSI Language (required) Example General: en-AU
url | Σ | 1..1 | url | The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle. Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 1..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 1..1 | dateTime | Date attachment was first created
format | Σ | 1..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context | Σ | 1..1 | BackboneElement | Clinical context of document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter |  | 0..* | Reference(Encounter | EpisodeOfCare) | Context of the document content
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Time of service that is being documented
facilityType |  | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 1..1 | Reference(Patient (CZ core)) {c} | Patient demographics from source
Slices for related |  | 0..* | Reference(Resource) | Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID |  | 0..1 | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | CZ DocumentEntry TypeCode ValueSet | 📦0.0.1 | This IG
DocumentReference.category | Base | required | CZ DocumentEntry ClassCode ValueSet | 📦0.0.1 | This IG
DocumentReference.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | required | V3 Value SetConfidentialityClassification | 📦2014-03-26 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📍3.0.0 | THO v6.5
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cz-mhd | error | DocumentReference | The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference | `conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | error | DocumentReference | 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 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DocumentReference

Summary

Mandatory: 17 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- uniqueId Identifier (https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.UniqueIdIdentifier)
- National health sector identifier (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-rid-identifier)
- Practitioner Role (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-practitionerrole-core)
- Patient (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-patient-core)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DocumentReference.context.related

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: cz-mhd
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 1..1 | code | Language of the resource content Binding: eHDSI Language (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 1..1 | UniqueIdIdentifier | Master Version Specific Identifier
status | ?!Σ | 1..1 | code | current | superseded Binding: DocumentReferenceStatus (required): The status of the document reference.
type | Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: CZ DocumentEntry TypeCode ValueSet (required)
category | Σ | 1..1 | CodeableConcept | Categorization of document Binding: CZ DocumentEntry ClassCode ValueSet (required)
subject | Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
identifier | Σ | 1..1 | CZ_RID_Identifier | Logical reference, when literal reference is not known
author | Σ | 0..* | Reference(Practitioner Role (CZ core)) {c} | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) {c} | Who/what authenticated the document
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
securityLabel | Σ | 1..* | CodeableConcept | Document security-tags Binding: V3 Value SetConfidentialityClassification (required)
content | Σ | 1..1 | BackboneElement | Document referenced
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
contentType | Σ | 1..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 1..1 | code | Human language of the content (BCP-47) Binding: eHDSI Language (required) Example General: en-AU
url | Σ | 1..1 | url | The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle. Example General: http://www.acme.com/logo-small.png
title | Σ | 1..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 1..1 | dateTime | Date attachment was first created
format | Σ | 1..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context | Σ | 1..1 | BackboneElement | Clinical context of document
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
facilityType |  | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 1..1 | Reference(Patient (CZ core)) {c} | Patient demographics from source
Slices for related |  | 0..* | Reference(Resource) | Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID |  | 0..1 | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | CZ DocumentEntry TypeCode ValueSet | 📦0.0.1 | This IG
DocumentReference.category | Base | required | CZ DocumentEntry ClassCode ValueSet | 📦0.0.1 | This IG
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | required | V3 Value SetConfidentialityClassification | 📦2014-03-26 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cz-mhd | error | DocumentReference | The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference | `conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | error | DocumentReference | 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 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from DocumentReference

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: cz-mhd
language |  | 1..1 | code | Language of the resource content Binding: eHDSI Language (required)
masterIdentifier |  | 1..1 | UniqueIdIdentifier | Master Version Specific Identifier
status |  | 1..1 | code | current | superseded
docStatus |  | 0..0 |  |
type |  | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: CZ DocumentEntry TypeCode ValueSet (required)
category |  | 1..1 | CodeableConcept | Categorization of document Binding: CZ DocumentEntry ClassCode ValueSet (required)
subject |  | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
identifier |  | 1..1 | CZ_RID_Identifier | Logical reference, when literal reference is not known
author |  | 0..* | Reference(Practitioner Role (CZ core)) {c} | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) {c} | Who/what authenticated the document
custodian |  | 0..0 |  |
relatesTo |  | 0..* | BackboneElement | Relationships to other documents
securityLabel |  | 1..* | CodeableConcept | Document security-tags Binding: V3 Value SetConfidentialityClassification (required)
content |  | 1..1 | BackboneElement | Document referenced
attachment |  |  |  |
contentType |  | 1..1 | code | Mime type of the content, with charset etc.
language |  | 1..1 | code | Human language of the content (BCP-47) Binding: eHDSI Language (required)
data |  | 0..0 |  |
url |  | 1..1 | url | The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle.
title |  | 1..1 | string | Label to display in place of the data
creation |  | 1..1 | dateTime | Date attachment was first created
format |  | 1..1 | Coding | Format/content rules for the document
context |  | 1..1 | BackboneElement | Clinical context of document
facilityType |  | 1..1 | CodeableConcept | Kind of facility where patient was seen
practiceSetting |  | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty)
sourcePatientInfo |  | 1..1 | Reference(Patient (CZ core)) {c} | Patient demographics from source
Slices for related |  | 0..* | Reference(Resource) | Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID |  | 0..1 | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.type | Base | required | CZ DocumentEntry TypeCode ValueSet | 📦0.0.1 | This IG
DocumentReference.category | Base | required | CZ DocumentEntry ClassCode ValueSet | 📦0.0.1 | This IG
DocumentReference.securityLabel | Base | required | V3 Value SetConfidentialityClassification | 📦2014-03-26 | FHIR Std.
DocumentReference.content.​attachment.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu

#### Constraints

Id | Grade | Path(s) | Description | Expression
cz-mhd | error | DocumentReference | The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference | `conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: cz-mhd
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 1..1 | code | Language of the resource content Binding: eHDSI Language (required)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 1..1 | UniqueIdIdentifier | Master Version Specific Identifier
identifier | Σ | 0..* | Identifier | Other identifiers for the document
status | ?!Σ | 1..1 | code | current | superseded Binding: DocumentReferenceStatus (required): The status of the document reference.
type | Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: CZ DocumentEntry TypeCode ValueSet (required)
category | Σ | 1..1 | CodeableConcept | Categorization of document Binding: CZ DocumentEntry ClassCode ValueSet (required)
subject | Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 1..1 | CZ_RID_Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
date | Σ | 0..1 | instant | When this document reference was created
author | Σ | 0..* | Reference(Practitioner Role (CZ core)) {c} | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) {c} | Who/what authenticated the document
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
description | Σ | 0..1 | string | Human-readable description
securityLabel | Σ | 1..* | CodeableConcept | Document security-tags Binding: V3 Value SetConfidentialityClassification (required)
content | Σ | 1..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | Σ | 1..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 1..1 | code | Human language of the content (BCP-47) Binding: eHDSI Language (required) Example General: en-AU
url | Σ | 1..1 | url | The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle. Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 1..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 1..1 | dateTime | Date attachment was first created
format | Σ | 1..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context | Σ | 1..1 | BackboneElement | Clinical context of document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter |  | 0..* | Reference(Encounter | EpisodeOfCare) | Context of the document content
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Time of service that is being documented
facilityType |  | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 1..1 | Reference(Patient (CZ core)) {c} | Patient demographics from source
Slices for related |  | 0..* | Reference(Resource) | Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID |  | 0..1 | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | CZ DocumentEntry TypeCode ValueSet | 📦0.0.1 | This IG
DocumentReference.category | Base | required | CZ DocumentEntry ClassCode ValueSet | 📦0.0.1 | This IG
DocumentReference.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | required | V3 Value SetConfidentialityClassification | 📦2014-03-26 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | required | eHDSI Language | ⏿8.1.0 | tx.hl7europe.eu
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📍3.0.0 | THO v6.5
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cz-mhd | error | DocumentReference | The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference | `conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | error | DocumentReference | 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 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DocumentReference

Summary

Mandatory: 17 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- uniqueId Identifier (https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.UniqueIdIdentifier)
- National health sector identifier (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-rid-identifier)
- Practitioner Role (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-practitionerrole-core)
- Patient (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-patient-core)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DocumentReference.context.related

Other representations of profile: CSV, Excel, Schematron