Content (cs)

Sekce a obsah

Dokument je rozdělen do sady povinných a nepovinných sekcí. V případě, že nejsou pro povinnou sekci k dispozici žádná data, lze odůvodnění vyjádřit v composition.section.emptyReason.

Struktura dokumentu

Zobrazovací zpráva obsahuje následující sekce v tomto pořadí:

Hlavička obrazové žádanky

Obecné informace o zprávě. Většina informačních prvků v této části zprávy se překrývá s jinými klinickými zprávami. Záhlaví dokumentu obsahuje informace o pacientovi, zdrojové organizaci, autorovi, ověřovateli a správci zprávy.

Klinická událost (encounter)

Tento profil umožňuje propojení žádanky s jednou konkrétní klinickou událostí, tj. například návštěvu ambulance, při které žádanka vznikla.

Tělo obrazové žádanky

Informace o objednávce

Tato požadovaná sekce zahrnuje povinný identifikátor žádanky (A.2.1.1), datum a čas jejího vytvoření (A.2.1.2) – pokud je založena sekce informací, musí tyto informace obsahovat. Mezi volitelné položky patří urgentnost objednávky (z pohledu indikujícího lékaře) vyjádřená mezinárodním kódem ze sytému HL7 (Request Priority) (A.2.1.4), který může nabývat hodnot routine (běžná priorita), urgent (spěchá), asap (co možná nejdříve) a stat (status iminens, STATIM). Další volitelnou položkou je datum a čas požadovaného vyšetření (A.2.1.3), zde se nejedná o termín skutečného objednání, otevírá se zde možnost např. zaslat žádanku s prosbou o objednání na den, kdy má pacient ambulantní klinickou kontrolu.

Další požadavky / podrobné specifikace zkoušky (A.2.1.5) je další volitelné pole, které může obsahovat další informace pro objednávku. To může zahrnovat například požadavek odesílajícího lékaře na použití specifického dohodnutého protokolu nebo provedení vyšetření na konkrétním přístroji MRI.

Poslední volitelnou položkou jsou informace pro pacienta, jako jsou požadavky na lačno, vysazení léků, rady ohledně klaustrofobie atd.

Odůvodnění vyšetření (klinická otázka)

Tato požadovaná sekce zahrnuje indikační diagnózu (A.2.2.1), která je vyžadována zdravotními pojišťovnami k proplacení služby. Další položky zahrnují klinickou otázku (věta tázací, měla by končit otazníkem a mělo by možné na ni na základě obrazového vyšetření odpovědět) případně zadanou i kódem SNOMED-CT a důvod objednávky (v podstatě odpovídá stručné epikríze, opět s možností zadat tutéž informaci pomocí kódu). Výhodou zadávání kódem by v budoucnu mohlo být provázání s již zadanými informacemi v NIS, Indikující lékař by tedy reálně tyto informace zadávat podruhé nemusel.

Platba

Tato část umožňuje upřesnění, pokud je část vyšetření hrazena jinak než většina (např. speciální rekonstrukce nehrazené pojištěním). I když je vyžadováno, aby byla tato část přítomna, není povinné ji vyplňovat, což znamená, že může být ponecháno prázdné, pokud to není možné.

Volný textový komentář k úhradě lze použít v případě potřeby upřesnit, kterou část péče hradí jiný plátce. To umožňuje jasnost a transparentnost, pokud jde o finanční odpovědnost a ujednání související s poskytovanými zdravotnickými službami.

Termín vyšetření (návštěvy)

Tato požadovaná sekce zahrnuje potvrzené informace z vyšetřujícího ZZ o objednávce, tj. na kdy je pacient objednán, kam má přijít, včetně volného textu komentáře (např. MR na 2. patře hlavní budovy). Využití těchto struktur předpokládá, že bude možné po přijetí žádanky vyšetřujícím ZZ tyto informace „doplnit“ neboli vytvořit aktualizovanou verzi žádanky tuto informaci obsahující.

Objednávky plánované péče

Odkazy na objednávky plánované péče navazující na tuto žádanku. Kromě ID by měl obsahovat i název této schůzky, ostatní informace by se měly automaticky doplnit z odkazované objednávky. Například “Konzultace na neurochirurgii”, přes ID pak zjistit, že bude v ÚVN 15.3.2040 v 16:15.

Implantáty

V této sekci je uveden seznam implantátů či pomůcek majících vliv na průběh vyšetření či jeho interpretaci.

Přílohy

Tato požadovaná sekce umožní přidat libovolný další zdroj informací (například ambulantní zprávy, propouštěcí zprávy – v digitální podobě nebo i jen scan, data poskytnutá pacientem atd. Opět není povinná, pouze otevíráme možnost libovolné přílohy).

Content (en)

Sections and content

The document is divided into a set of mandatory and optional sections. In case no data is available for a mandatory section, the justification can be expressed in composition.section.emptyReason.

Document structure

The Imaging order holds the following sections in this order:

Imaging Order Header

General information on the order. Most of the information elements in this part of the order overlap with other clinical orders. The document header includes information on the patient, source organization, author, attester and custodian of the order.

Clinical Encounter (Encounter)

This profile allows for linking the order form to a specific clinical encounter, such as an outpatient visit during which the order was created.

Body of the Imaging Order

Order Information

This mandatory section includes the required order identifier (A.2.1.1) and the date and time of its creation (A.2.1.2) — if the information section is established, it must contain these details. Optional items include the urgency of the order (from the perspective of Indicating Physician) expressed by an international code from the HL7 system (Request Priority) (A.2.1.4), which can have values such as routine (normal priority), urgent (urgent case), asap (as soon as possible) and stat (status iminens / STATIM). Another optional item is the requested date and time of the examination (A.2.1.3), which does not refer to the actual booking date but opens the possibility, for example, to send an order form with a request for scheduling on the day when the patient has an outpatient clinical check-up.

Additional Requirements / Detailed Examination Specifications (A.2.1.5) is another optional field that can contain extra information for the order. This could include, for example, the Referring physician request for using a specific agreed-upon protocol or conducting the examination on a specific MRI machine.

The final optional item is information for the patient, such as fasting requirements, medication discontinuation, advice on claustrophobia, etc.

Justification for Examination (Clinical question)

This required section includes the indicative diagnosis (A.2.2.1), which is required by health insurance companies for service reimbursement. Additional items include the clinical question (an interrogative sentence that should end with a question mark and should be answerable based on the imaging examination) which can also be assigned a SNOMED CT code, and the reason for the order (essentially a brief summary, again with the option to encode the information). The advantage of using a code in the future could be the integration with existing information in the Indicating Physician's system within the NIS (Nursing Information System), thereby eliminating the need to re-enter this information.

Payment (Coverage)

This section allows for specification if part of the examination is covered differently than the majority of it (e.g. special reconstructions not covered by insurance). While this section is required to be present, it is not mandatory to fill it out, meaning it can be left blank if not applicable.

A free text comment on payment can be used when there is a need to specify which part of the care is covered by a different payer. This allows for clarity and transparency regarding the financial responsibilities and arrangements associated with the provided healthcare services.

Examination Appointment (Visit)

This mandatory section includes confirmed information from the examining healthcare facility about the appointment, such as when the patient is scheduled, where they need to go, and may include free text comments (e.g. MRI on the 2nd floor of the main building). The use of these structures assumes that it will be possible, after the order has been received by the examining healthcare facility, to "supplement" this information or create an updated version of the order form that includes this information.

Care plans

This section contains references to scheduled care plan orders that follow from this order form. Besides the ID, it should include the name of the appointment, with other details being automatically populated from the referenced order. For example, an entry may state "Consultation in Neurosurgery" and by using the ID, one can determine that it is scheduled at the Central Military Hospital on March 15, 2040, at 16:15. This facilitates efficient tracking and management of the patient’s care pathway.

Medical Devices (Implants)

This section contains a list of implants or devices that affect the course of the examination or its interpretation.

Attachments

This optional section allows for the inclusion of any additional sources of information, such as outpatient reports, discharge summaries (in digital form or even just a scan), data provided by the patient, etc. While this section is not mandatory, it provides the flexibility to attach various types of files or documents to supplement the order form with relevant information.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition	C	0..*	Composition	Imaging Order Composition Constraints: text-or-section
meta	Σ	0..1	Meta	Metadata about the resource
security	SΣ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:relatedArtifact		0..*	(Complex)	Related artefacts: e.g. presented form URL: http://hl7.org/fhir/StructureDefinition/artifact-relatedArtifact
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/artifact-relatedArtifact"
value[x]		1..1	RelatedArtifact	Value of extension
type	Σ	1..1	code	documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of Binding: RelatedArtifactType (required): The type of relationship to the related artifact. Example presented form: {"coding":[{"system":"http://hl7.org/fhir/related-artifact-type","code":"documentation"}]}
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Order identifier
status	?!Σ	1..1	code	Status of the Order Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: CZ Composition Type (preferred)
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:loinc	Σ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18748-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (required)
subject	Σ	1..1	Reference(Patient (CZ core))	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter (CZ))	Context that defines the Imaging Order
date	Σ	1..1	dateTime	Date the order was created.
author	Σ	1..*	Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Device: Performer/Observer (CZ))	Who and/or what authored the Imaging order
title	Σ	1..1	string	Human Readable name/title
custodian	Σ	0..1	Reference(Organization (CZ core))	Organization that manages the Imaging Order
Slices for section	C	2..*	BackboneElement	Sections composing the Imaging Order Slice: Unordered, Open by value:code Constraints: cmp-1, cmp-2
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
section:orderInformation	C	1..*	BackboneElement	Order Information Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55115-0
display		1..1	string	Representation defined by the system Fixed Value: Requested imaging studies information Document
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
entry	C	0..*	Reference(Service Request: Imaging Order (CZ))	A reference to data that supports this section
section:clinicalQuestion	C	1..*	BackboneElement	Clinical question Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18785-6
display		1..1	string	Representation defined by the system Fixed Value: Radiology Reason for study (narrative)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Device: Performer/Observer (CZ) | Patient (CZ core) | Related Person (CZ core) | Organization (CZ core))	Who and/or what authored the section
text	C	1..1	Narrative	Clinical question text This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry	C	0..*	Reference(Condition: Imaging Order (CZ))	A reference to data that supports this section
section:coverage	C	0..*	BackboneElement	Coverage type Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 87520-3
display		1..1	string	Representation defined by the system Fixed Value: Coverage type
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
entry	C	0..*	Reference(Coverage (CZ))	A reference to data that supports this section
section:appointment	C	0..1	BackboneElement	Appointment Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 56446-8
display		1..1	string	Representation defined by the system Fixed Value: Appointment summary Document
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
entry	C	0..*	Reference(Appointment: Imaging Order (CZ))	A reference to data that supports this section
section:carePlan	C	0..1	BackboneElement	Care Plan Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18776-5
display		1..1	string	Representation defined by the system Fixed Value: Plan of care note
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
entry	C	0..*	Reference(Care plan: Imaging Order (CZ))	A reference to data that supports this section
section:medicalDevices	C	0..*	BackboneElement	Medical Devices and implants Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97813-0
display		1..1	string	Representation defined by the system Fixed Value: Implant component
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
entry	C	0..*	Reference(Device Use Statement: Imaging Order (CZ))	A reference to data that supports this section
section:attachments	C	0..*	BackboneElement	Library of attachments Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 77599-9
display		1..1	string	Representation defined by the system Fixed Value: Additional documentation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
entry	C	0..*	Reference(Attachment (CZ))	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Composition.extension:relatedArtifact.value[x].type	required	RelatedArtifactType http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 From the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
Composition.type	preferred	CZ_CompositionTypeVs https://hl7.cz/fhir/img-order/ValueSet/cz-composition-type-vs From this IG
Composition.category	required	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
Composition.section:orderInformation.code	example	Pattern Value: LOINC Code 55115-0("Requested imaging studies information Document") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:clinicalQuestion.code	example	Pattern Value: LOINC Code 18785-6("Radiology Reason for study (narrative)") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:coverage.code	example	Pattern Value: LOINC Code 87520-3("Coverage type") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:appointment.code	example	Pattern Value: LOINC Code 56446-8("Appointment summary Document") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:carePlan.code	example	Pattern Value: LOINC Code 18776-5("Plan of care note") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:medicalDevices.code	example	Pattern Value: LOINC Code 97813-0("Implant component") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:attachments.code	example	Pattern Value: LOINC Code 77599-9("Additional documentation") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:orderInformation, Composition.section:clinicalQuestion, Composition.section:coverage, Composition.section:appointment, Composition.section:carePlan, Composition.section:medicalDevices, Composition.section:attachments	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:orderInformation, Composition.section:clinicalQuestion, Composition.section:coverage, Composition.section:appointment, Composition.section:carePlan, Composition.section:medicalDevices, Composition.section:attachments	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	Composition	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	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	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()
text-or-section	error	Composition	A Composition SHALL have either text, at least one section, or both. : text.exists() or section.exists()

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition	C	0..*	Composition	Imaging Order Composition Constraints: text-or-section
meta
security	S	0..*	Coding	Security Labels applied to this resource
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:relatedArtifact		0..*	(Complex)	Related artefacts: e.g. presented form URL: http://hl7.org/fhir/StructureDefinition/artifact-relatedArtifact
extension		0..0
value[x]
type		1..1	code	documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of Example presented form: {"coding":[{"system":"http://hl7.org/fhir/related-artifact-type","code":"documentation"}]}
identifier		0..1	Identifier	Order identifier
status		1..1	code	Status of the Order
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: CZ Composition Type (preferred)
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:loinc		1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18748-4
category		0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (required)
subject		1..1	Reference(Patient (CZ core))	Who and/or what the composition is about
encounter		0..1	Reference(Encounter (CZ))	Context that defines the Imaging Order
date		1..1	dateTime	Date the order was created.
author		1..*	Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Device: Performer/Observer (CZ))	Who and/or what authored the Imaging order
custodian		0..1	Reference(Organization (CZ core))	Organization that manages the Imaging Order
Slices for section		2..*	BackboneElement	Sections composing the Imaging Order Slice: Unordered, Open by value:code
section:orderInformation		1..*	BackboneElement	Order Information
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55115-0
display		1..1	string	Representation defined by the system Fixed Value: Requested imaging studies information Document
entry		0..*	Reference(Service Request: Imaging Order (CZ))	A reference to data that supports this section
section:clinicalQuestion		1..*	BackboneElement	Clinical question
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18785-6
display		1..1	string	Representation defined by the system Fixed Value: Radiology Reason for study (narrative)
author		0..*	Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Device: Performer/Observer (CZ) | Patient (CZ core) | Related Person (CZ core) | Organization (CZ core))	Who and/or what authored the section
text		1..1	Narrative	Clinical question text
entry		0..*	Reference(Condition: Imaging Order (CZ))	A reference to data that supports this section
section:coverage		0..*	BackboneElement	Coverage type
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 87520-3
display		1..1	string	Representation defined by the system Fixed Value: Coverage type
entry		0..*	Reference(Coverage (CZ))	A reference to data that supports this section
section:appointment		0..1	BackboneElement	Appointment
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 56446-8
display		1..1	string	Representation defined by the system Fixed Value: Appointment summary Document
entry		0..*	Reference(Appointment: Imaging Order (CZ))	A reference to data that supports this section
section:carePlan		0..1	BackboneElement	Care Plan
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18776-5
display		1..1	string	Representation defined by the system Fixed Value: Plan of care note
entry		0..*	Reference(Care plan: Imaging Order (CZ))	A reference to data that supports this section
section:medicalDevices		0..*	BackboneElement	Medical Devices and implants
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97813-0
display		1..1	string	Representation defined by the system Fixed Value: Implant component
entry		0..*	Reference(Device Use Statement: Imaging Order (CZ))	A reference to data that supports this section
section:attachments		0..*	BackboneElement	Library of attachments
code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 77599-9
display		1..1	string	Representation defined by the system Fixed Value: Additional documentation
entry		0..*	Reference(Attachment (CZ))	A reference to data that supports this section
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	preferred	CZ_CompositionTypeVs https://hl7.cz/fhir/img-order/ValueSet/cz-composition-type-vs From this IG
Composition.category	required	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
text-or-section	error	Composition	A Composition SHALL have either text, at least one section, or both. : text.exists() or section.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition	C	0..*	Composition	Imaging Order Composition Constraints: text-or-section
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	SΣ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:relatedArtifact		0..*	(Complex)	Related artefacts: e.g. presented form URL: http://hl7.org/fhir/StructureDefinition/artifact-relatedArtifact
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/artifact-relatedArtifact"
value[x]		1..1	RelatedArtifact	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	1..1	code	documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of Binding: RelatedArtifactType (required): The type of relationship to the related artifact. Example presented form: {"coding":[{"system":"http://hl7.org/fhir/related-artifact-type","code":"documentation"}]}
label	Σ	0..1	string	Short label
display	Σ	0..1	string	Brief description of the related artifact
citation	Σ	0..1	markdown	Bibliographic citation for the artifact
url	Σ	0..1	url	Where the artifact can be accessed
document	Σ	0..1	Attachment	What document is being referenced
resource	Σ	0..1	canonical(Resource)	What resource is being referenced
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Order identifier
status	?!Σ	1..1	code	Status of the Order Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: CZ Composition Type (preferred)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:loinc	Σ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18748-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (required)
subject	Σ	1..1	Reference(Patient (CZ core))	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter (CZ))	Context that defines the Imaging Order
date	Σ	1..1	dateTime	Date the order was created.
author	Σ	1..*	Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Device: Performer/Observer (CZ))	Who and/or what authored the Imaging order
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
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
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
custodian	Σ	0..1	Reference(Organization (CZ core))	Organization that manages the Imaging Order
relatesTo		0..*	BackboneElement	Relationships to other compositions/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		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
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	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	C	2..*	BackboneElement	Sections composing the Imaging Order Slice: Unordered, Open by value:code Constraints: cmp-1, cmp-2
section:All Slices				Content/Rules for all slices
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
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:orderInformation	C	1..*	BackboneElement	Order Information Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55115-0
display		1..1	string	Representation defined by the system Fixed Value: Requested imaging studies information Document
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Service Request: Imaging Order (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:clinicalQuestion	C	1..*	BackboneElement	Clinical question Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18785-6
display		1..1	string	Representation defined by the system Fixed Value: Radiology Reason for study (narrative)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Device: Performer/Observer (CZ) | Patient (CZ core) | Related Person (CZ core) | Organization (CZ core))	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	1..1	Narrative	Clinical question text This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Condition: Imaging Order (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:coverage	C	0..*	BackboneElement	Coverage type Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 87520-3
display		1..1	string	Representation defined by the system Fixed Value: Coverage type
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Coverage (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:appointment	C	0..1	BackboneElement	Appointment Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 56446-8
display		1..1	string	Representation defined by the system Fixed Value: Appointment summary Document
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Appointment: Imaging Order (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:carePlan	C	0..1	BackboneElement	Care Plan Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 18776-5
display		1..1	string	Representation defined by the system Fixed Value: Plan of care note
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Care plan: Imaging Order (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:medicalDevices	C	0..*	BackboneElement	Medical Devices and implants Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97813-0
display		1..1	string	Representation defined by the system Fixed Value: Implant component
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Device Use Statement: Imaging Order (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:attachments	C	0..*	BackboneElement	Library of attachments Constraints: cmp-1, cmp-2
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
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 77599-9
display		1..1	string	Representation defined by the system Fixed Value: Additional documentation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Attachment (CZ))	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Composition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags From the FHIR Standard
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.extension:relatedArtifact.value[x].type	required	RelatedArtifactType http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 From the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
Composition.type	preferred	CZ_CompositionTypeVs https://hl7.cz/fhir/img-order/ValueSet/cz-composition-type-vs From this IG
Composition.category	required	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 From the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 From the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:orderInformation.code	example	Pattern Value: LOINC Code 55115-0("Requested imaging studies information Document") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:orderInformation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:orderInformation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:orderInformation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:clinicalQuestion.code	example	Pattern Value: LOINC Code 18785-6("Radiology Reason for study (narrative)") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:clinicalQuestion.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:clinicalQuestion.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:clinicalQuestion.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:coverage.code	example	Pattern Value: LOINC Code 87520-3("Coverage type") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:coverage.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:coverage.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:coverage.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:appointment.code	example	Pattern Value: LOINC Code 56446-8("Appointment summary Document") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:appointment.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:appointment.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:appointment.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:carePlan.code	example	Pattern Value: LOINC Code 18776-5("Plan of care note") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:carePlan.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:carePlan.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:carePlan.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:medicalDevices.code	example	Pattern Value: LOINC Code 97813-0("Implant component") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:medicalDevices.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:medicalDevices.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:medicalDevices.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard
Composition.section:attachments.code	example	Pattern Value: LOINC Code 77599-9("Additional documentation") http://hl7.org/fhir/ValueSet/doc-section-codes From the FHIR Standard
Composition.section:attachments.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section:attachments.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order From the FHIR Standard
Composition.section:attachments.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:orderInformation, Composition.section:clinicalQuestion, Composition.section:coverage, Composition.section:appointment, Composition.section:carePlan, Composition.section:medicalDevices, Composition.section:attachments	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:orderInformation, Composition.section:clinicalQuestion, Composition.section:coverage, Composition.section:appointment, Composition.section:carePlan, Composition.section:medicalDevices, Composition.section:attachments	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	Composition	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	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	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()
text-or-section	error	Composition	A Composition SHALL have either text, at least one section, or both. : text.exists() or section.exists()