HL7 Czech Imaging Report IG
0.1.0-ballot - ci-build Czechia flag

HL7 Czech Imaging Report IG, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/img/ and changes regularly. See the Directory of published versions

Resource Profile: CZ_CompositionImagingReport - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the cz-composition-imaging resource profile.

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

0. Composition
Definition

Imaging Study Report composition.

A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.

While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

The text field of each section SHALL contain a textual representation of all listed entries.


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

ShortImaging Report compositionA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

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

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
text-or-section: A Composition SHALL have either text, at least one section, or both. (text.exists() or section.exists())
2. Composition.meta
Definition

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

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

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

ShortSecurity Labels applied to this resource
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
(extensible to http://hl7.org/fhir/ValueSet/security-labels)

Security Labels from the Healthcare Privacy and Security Classification System.

TypeCoding
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Composition.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

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

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. Composition.extension:diagnosticreport-reference
    Slice Namediagnosticreport-reference
    Definition

    This extension provides a reference to the DiagnosticReport instance that is associated with this Composition.

    ShortDocument DiagnosticReport Reference
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(Diagnostic Report: Imaging Report (CZ)))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Composition.extension:basedOn-order-or-requisition
    Slice NamebasedOn-order-or-requisition
    Definition

    This extension provides a link to the order [(Reference(ServiceRequest)] or requisition [ServiceRequest.requisition (i.e., 'Request.groupIdentifier')] that this report document is based on and fulfills.

    ShortComposition: Based On Order
    Control0..*
    TypeExtension(Composition: Based On Order) (Extension Type: Choice of: Identifier, Reference(ServiceRequest))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Composition.extension:basedOn-order-or-requisition.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Composition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 16. Composition.extension:basedOn-order-or-requisition.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.eu/fhir/StructureDefinition/composition-basedOn-order-or-requisition
      18. Composition.extension:basedOn-order-or-requisition.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control0..1
      This element is affected by the following invariants: ext-1
      TypeChoice of: Identifier, Reference(ServiceRequest), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Composition.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 20. Composition.extension:basedOn-order-or-requisition.value[x]:valueReference
        Slice NamevalueReference
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control0..1
        This element is affected by the following invariants: ext-1
        TypeReference(Service Request: Imaging Report (CZ)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Composition.extension:basedOn
        Slice NamebasedOn
        Definition

        A plan, proposal or order that is fulfilled in whole or in part by this event.

        ShortFulfills plan, proposal or order
        Control0..*
        TypeExtension(Based on) (Extension Type: Reference(Resource))
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        24. Composition.extension:informationRecipient
        Slice NameinformationRecipient
        Definition

        This extension applies to the Composition resource and is used to represent an intended recipient of the composition.

        ShortComposition: Information recipient
        Control0..*
        TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        26. Composition.extension:informationRecipient.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

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

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Composition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 28. Composition.extension:informationRecipient.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.eu/fhir/StructureDefinition/information-recipient
          30. Composition.extension:informationRecipient.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control0..1
          This element is affected by the following invariants: ext-1
          TypeReference(Practitioner (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Practitioner Role (CZ core), Organization (CZ core)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Composition.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored
          Comments

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

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

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

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

          Identifiers assigned to this Imaging Report by the performer or other systems. It shall be common to several report versions


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

          ShortReport identifierVersion-independent identifier for the Composition
          Comments

          Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists


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

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

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

          ShortStatus of the Reportpreliminary | final | amended | entered-in-error
          Comments

          DiagnosticReport.status and Composition.status shall be aligned


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

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

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

          The workflow/clinical status of the composition.

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

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

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

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

          ShortKind of composition (LOINC if possible)
          Comments

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

          Control1..1
          BindingThe codes SHOULD be taken from FHIRDocumentTypeCodeshttp://hl7.org/fhir/ValueSet/doc-typecodes
          (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes)

          Type of a composition.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

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

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

          Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

          ShortWho and/or what the composition is about
          Comments

          For clinical documents, this is usually the patient.

          Control10..1
          TypeReference(Patient (CZ core), Resource)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

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

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

          ShortDate the report was last changed.Composition editing time
          Comments

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

          Control1..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

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


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

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

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

          ShortWho and/or what authored the Imaging orderWho and/or what authored the composition
          Control1..*
          TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core), Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summarytrue
          Requirements

          Identifies who is responsible for the content.

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

          Official human-readable label for the composition.

          ShortHuman Readable name/title
          Comments

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

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Composition.attester
          Definition

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

          ShortAttests to accuracy of composition
          Comments

          Only list each attester once.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Identifies responsibility for the accuracy of the composition content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ mode
          • 50. Composition.attester.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

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

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

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

            The type of attestation the authenticator offers.

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

            The way in which a person authenticated a composition.

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

            Indicates the level of authority of the attestation.

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

            Who attested the composition in the specified way.

            ShortWho attested the composition
            Control0..1
            TypeReference(Patient (CZ core), Related Person (CZ core), Practitioner (CZ core), Practitioner Role (CZ core), Organization (CZ core), Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

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

            ShortAttests to accuracy of composition
            Comments

            Only list each attester once.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Identifies responsibility for the accuracy of the composition content.

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

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

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

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

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

            The type of attestation the authenticator offers.

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

            The way in which a person authenticated a composition.

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

            Indicates the level of authority of the attestation.

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

            Who attested the composition in the specified way.

            ShortWho attested the composition
            Control0..1
            TypeReference(Practitioner Role (CZ core), Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

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

            ShortAttests to accuracy of composition
            Comments

            Only list each attester once.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Identifies responsibility for the accuracy of the composition content.

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

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

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

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

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

            The type of attestation the authenticator offers.

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

            The way in which a person authenticated a composition.

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

            Indicates the level of authority of the attestation.

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

            Who attested the composition in the specified way.

            ShortWho attested the composition
            Control0..1
            TypeReference(Practitioner Role (CZ core), Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

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

            ShortOrganization that manages the Imaging ReportOrganization which maintains the composition
            Comments

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

            Control0..1
            TypeReference(Organization (CZ core), Organization)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

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

            The root of the sections that make up the composition.

            ShortComposition is broken into sections
            Control40..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ code
            • 76. Composition.section.modifierExtension
              Definition

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

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

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

              ShortWho and/or what authored the section
              Control0..*
              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core), Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
              Is Modifierfalse
              Summaryfalse
              Requirements

              Identifies who is responsible for the content.

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

              This section holds information related to the imaging studies covered by this report.


              The root of the sections that make up the composition.

              ShortImaging StudyComposition is broken into sections
              Control10..1*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              82. Composition.section:imagingstudy.modifierExtension
              Definition

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

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

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

              ShortClassification of section (recommended)
              Comments

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

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

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

              Classification of a section of a composition/document.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Provides computable standardized labels to topics within the document.

              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "18726-0",
                  "display" : "Radiology studies (set)"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Composition.section:imagingstudy.entry
              Definition

              This entry holds a reference to the Imaging Study instance that is associated with this Composition.


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

              ShortImaging Study ReferenceA reference to data that supports this section
              Comments

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

              Control10..*
              This element is affected by the following invariants: cmp-2
              TypeReference(Imaging Study (CZ), Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. Composition.section:order
              Slice Nameorder
              Definition

              This section holds information related to the order for the imaging study.


              The root of the sections that make up the composition.

              ShortOrderComposition is broken into sections
              Control10..1*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              90. Composition.section:order.modifierExtension
              Definition

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

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

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

              ShortClassification of section (recommended)
              Comments

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

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

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

              Classification of a section of a composition/document.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Provides computable standardized labels to topics within the document.

              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "55115-0",
                  "display" : "Requested imaging studies information Document"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. Composition.section:order.entry
              Definition

              This entry holds a reference to the order for the Imaging Study and report.


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

              ShortOrder referenceA reference to data that supports this section
              Comments

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

              Control0..*
              This element is affected by the following invariants: cmp-2
              TypeReference(Service Request: Imaging Report (CZ), Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              96. Composition.section:clinicalQuestion
              Slice NameclinicalQuestion
              Definition

              This section holds information about the clinical question that the imaging method is intended to answer.


              The root of the sections that make up the composition.

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

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

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

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

              ShortClassification of section (recommended)
              Comments

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

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

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

              Classification of a section of a composition/document.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Provides computable standardized labels to topics within the document.

              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "18785-6",
                  "display" : "Radiology Reason for study (narrative)"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              102. Composition.section:clinicalQuestion.text
              Definition

              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

              ShortText summary of the section, for human interpretation
              Comments

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

              Control10..1
              This element is affected by the following invariants: cmp-1
              TypeNarrative
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Composition.section:clinicalQuestion.entry
              Definition

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

              ShortA reference to data that supports this section
              Comments

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

              Control0..*
              This element is affected by the following invariants: cmp-2
              TypeReference(Condition: Imaging Report (CZ), Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Composition.section:history
              Slice Namehistory
              Definition

              This section includes patient history and other prior clinical details deemed relevant to the imaging study by the imaging clinician.


              The root of the sections that make up the composition.

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

              An Extension


              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortExtensionAdditional content defined by implementations
              Comments

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

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 110. Composition.section:history.extension:note
                Slice Namenote
                Definition

                Additional notes that apply to this resource or element.

                ShortAdditional notes that apply to this resource or element.
                Comments

                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                Control0..*
                TypeExtension(Note) (Extension Type: Annotation)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                112. Composition.section:history.modifierExtension
                Definition

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

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

                ShortClassification of section (recommended)
                Comments

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

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

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

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "11329-0",
                    "display" : "History general Narrative - Reported"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                116. Composition.section:procedure
                Slice Nameprocedure
                Definition

                This section contains information such as the procedure type, the anatomy imaged, the date and time of the imaging examination, and the facility that performed it.


                The root of the sections that make up the composition.

                ShortProcedureComposition is broken into sections
                Control10..1*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                118. Composition.section:procedure.modifierExtension
                Definition

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

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

                ShortClassification of section (recommended)
                Comments

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

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

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

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "55111-9",
                    "display" : "Current imaging procedure descriptions Document"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. Composition.section:procedure.entry
                Definition

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

                ShortA reference to data that supports this section
                Comments

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

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Procedure: Imaging Report (CZ), Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. Composition.section:comparison
                Slice Namecomparison
                Definition

                The root of the sections that make up the composition.

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

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

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

                ShortClassification of section (recommended)
                Comments

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

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

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

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "18834-2",
                    "display" : "Radiology Comparison study (narrative)"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                130. Composition.section:comparison.entry
                Definition

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

                ShortA reference to data that supports this section
                Comments

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

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Imaging Study (CZ), Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                132. Composition.section:findings
                Slice Namefindings
                Definition

                The root of the sections that make up the composition.

                ShortFindingsComposition is broken into sections
                Control10..1*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                134. Composition.section:findings.modifierExtension
                Definition

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

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

                ShortClassification of section (recommended)
                Comments

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

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

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

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "59776-5",
                    "display" : "Procedure findings Narrative"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. Composition.section:findings.entry
                Definition

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

                ShortA reference to data that supports this section
                Comments

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

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Observation: Imaging Report (CZ), Imaging Key Image Document Reference: Imaging Report (CZ), Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                140. Composition.section:impression
                Slice Nameimpression
                Definition

                The root of the sections that make up the composition.

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

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

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

                ShortClassification of section (recommended)
                Comments

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

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

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

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "19005-8",
                    "display" : "Radiology Imaging study [Impression] (narrative)"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                146. Composition.section:impression.entry
                Definition

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

                ShortA reference to data that supports this section
                Comments

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

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Observation: Imaging Report (CZ), Condition: Imaging Report (CZ), Imaging Key Image Document Reference: Imaging Report (CZ), Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                148. Composition.section:recommendation
                Slice Namerecommendation
                Definition

                The root of the sections that make up the composition.

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

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

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

                ShortClassification of section (recommended)
                Comments

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

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

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

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "18783-1",
                    "display" : "Radiology Study recommendation (narrative)"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                154. Composition.section:recommendation.entry
                Definition

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

                ShortA reference to data that supports this section
                Comments

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

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Care plan: Imaging Report (CZ), Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                156. Composition.section:communication
                Slice Namecommunication
                Definition

                The root of the sections that make up the composition.

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

                An Extension


                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortExtensionAdditional content defined by implementations
                Comments

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

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 160. Composition.section:communication.extension:note
                  Slice Namenote
                  Definition

                  Additional notes that apply to this resource or element.

                  ShortAdditional notes that apply to this resource or element.
                  Comments

                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                  Control0..*
                  TypeExtension(Note) (Extension Type: Annotation)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  162. Composition.section:communication.modifierExtension
                  Definition

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

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

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

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

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

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

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

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

                  ShortClassification of section (recommended)
                  Comments

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

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

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

                  Classification of a section of a composition/document.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Provides computable standardized labels to topics within the document.

                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "73575-3",
                      "display" : "Radiology Consult note"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                  0. Composition
                  Definition

                  Imaging Study Report composition.

                  A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.

                  While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

                  The text field of each section SHALL contain a textual representation of all listed entries.

                  ShortImaging Report composition
                  Invariantstext-or-section: A Composition SHALL have either text, at least one section, or both. (text.exists() or section.exists())
                  2. Composition.meta
                  4. Composition.meta.security
                  Must Supporttrue
                  6. Composition.extension
                  Control1..?
                  SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 8. Composition.extension:diagnosticreport-reference
                    Slice Namediagnosticreport-reference
                    Control1..1
                    TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(Diagnostic Report: Imaging Report (CZ)))
                    10. Composition.extension:basedOn-order-or-requisition
                    Slice NamebasedOn-order-or-requisition
                    Control0..*
                    TypeExtension(Composition: Based On Order) (Extension Type: Choice of: Identifier, Reference(ServiceRequest))
                    12. Composition.extension:basedOn-order-or-requisition.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    SlicingThis element introduces a set of slices on Composition.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 14. Composition.extension:basedOn-order-or-requisition.value[x]:valueReference
                      Slice NamevalueReference
                      Control0..1
                      TypeReference(Service Request: Imaging Report (CZ))
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      16. Composition.extension:basedOn
                      Slice NamebasedOn
                      Control0..*
                      TypeExtension(Based on) (Extension Type: Reference(Resource))
                      18. Composition.extension:informationRecipient
                      Slice NameinformationRecipient
                      Control0..*
                      TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                      20. Composition.extension:informationRecipient.value[x]
                      TypeReference(Practitioner (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Practitioner Role (CZ core), Organization (CZ core))
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      22. Composition.identifier
                      Definition

                      Identifiers assigned to this Imaging Report by the performer or other systems. It shall be common to several report versions

                      ShortReport identifier
                      Comments

                      Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      24. Composition.status
                      ShortStatus of the Report
                      Comments

                      DiagnosticReport.status and Composition.status shall be aligned

                      26. Composition.subject
                      Control1..?
                      TypeReference(Patient (CZ core))
                      Must Supporttrue
                      28. Composition.date
                      ShortDate the report was last changed.
                      Must Supporttrue
                      30. Composition.author
                      ShortWho and/or what authored the Imaging order
                      TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                      32. Composition.attester
                      Must Supporttrue
                      SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ mode
                      • 34. Composition.attester.party
                        TypeReference(Patient (CZ core), Related Person (CZ core), Practitioner (CZ core), Practitioner Role (CZ core), Organization (CZ core))
                        36. Composition.attester:legalAuthenticator
                        Slice NamelegalAuthenticator
                        Control0..*
                        Must Supporttrue
                        38. Composition.attester:legalAuthenticator.mode
                        Must Supporttrue
                        Pattern Valuelegal
                        40. Composition.attester:legalAuthenticator.party
                        TypeReference(Practitioner Role (CZ core))
                        42. Composition.attester:resultValidator
                        Slice NameresultValidator
                        Control0..*
                        Must Supporttrue
                        44. Composition.attester:resultValidator.mode
                        Must Supporttrue
                        Pattern Valueprofessional
                        46. Composition.attester:resultValidator.party
                        TypeReference(Practitioner Role (CZ core))
                        48. Composition.custodian
                        ShortOrganization that manages the Imaging Report
                        TypeReference(Organization (CZ core))
                        Must Supporttrue
                        50. Composition.section
                        Control4..?
                        SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ code
                        • 52. Composition.section.author
                          TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                          54. Composition.section:imagingstudy
                          Slice Nameimagingstudy
                          Definition

                          This section holds information related to the imaging studies covered by this report.

                          ShortImaging Study
                          Control1..1
                          56. Composition.section:imagingstudy.code
                          Control1..?
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "18726-0",
                              "display" : "Radiology studies (set)"
                            }]
                          }
                          58. Composition.section:imagingstudy.entry
                          Definition

                          This entry holds a reference to the Imaging Study instance that is associated with this Composition.

                          ShortImaging Study Reference
                          Control1..?
                          TypeReference(Imaging Study (CZ))
                          60. Composition.section:order
                          Slice Nameorder
                          Definition

                          This section holds information related to the order for the imaging study.

                          ShortOrder
                          Control1..1
                          62. Composition.section:order.code
                          Control1..?
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "55115-0",
                              "display" : "Requested imaging studies information Document"
                            }]
                          }
                          64. Composition.section:order.entry
                          Definition

                          This entry holds a reference to the order for the Imaging Study and report.

                          ShortOrder reference
                          TypeReference(Service Request: Imaging Report (CZ))
                          66. Composition.section:clinicalQuestion
                          Slice NameclinicalQuestion
                          Definition

                          This section holds information about the clinical question that the imaging method is intended to answer.

                          ShortClinical question
                          Control0..*
                          68. Composition.section:clinicalQuestion.code
                          Control1..?
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "18785-6",
                              "display" : "Radiology Reason for study (narrative)"
                            }]
                          }
                          70. Composition.section:clinicalQuestion.text
                          Control1..?
                          72. Composition.section:clinicalQuestion.entry
                          TypeReference(Condition: Imaging Report (CZ))
                          74. Composition.section:history
                          Slice Namehistory
                          Definition

                          This section includes patient history and other prior clinical details deemed relevant to the imaging study by the imaging clinician.

                          ShortHistory
                          Control0..1
                          76. Composition.section:history.extension
                          SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 78. Composition.section:history.extension:note
                            Slice Namenote
                            Control0..*
                            TypeExtension(Note) (Extension Type: Annotation)
                            80. Composition.section:history.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "11329-0",
                                "display" : "History general Narrative - Reported"
                              }]
                            }
                            82. Composition.section:procedure
                            Slice Nameprocedure
                            Definition

                            This section contains information such as the procedure type, the anatomy imaged, the date and time of the imaging examination, and the facility that performed it.

                            ShortProcedure
                            Control1..1
                            84. Composition.section:procedure.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "55111-9",
                                "display" : "Current imaging procedure descriptions Document"
                              }]
                            }
                            86. Composition.section:procedure.entry
                            TypeReference(Procedure: Imaging Report (CZ))
                            88. Composition.section:comparison
                            Slice Namecomparison
                            ShortComparison
                            Control0..1
                            90. Composition.section:comparison.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "18834-2",
                                "display" : "Radiology Comparison study (narrative)"
                              }]
                            }
                            92. Composition.section:comparison.entry
                            TypeReference(Imaging Study (CZ))
                            94. Composition.section:findings
                            Slice Namefindings
                            ShortFindings
                            Control1..1
                            96. Composition.section:findings.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "59776-5",
                                "display" : "Procedure findings Narrative"
                              }]
                            }
                            98. Composition.section:findings.entry
                            TypeReference(Observation: Imaging Report (CZ), Imaging Key Image Document Reference: Imaging Report (CZ))
                            100. Composition.section:impression
                            Slice Nameimpression
                            ShortImpressions
                            Control0..1
                            102. Composition.section:impression.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "19005-8",
                                "display" : "Radiology Imaging study [Impression] (narrative)"
                              }]
                            }
                            104. Composition.section:impression.entry
                            TypeReference(Observation: Imaging Report (CZ), Condition: Imaging Report (CZ), Imaging Key Image Document Reference: Imaging Report (CZ))
                            106. Composition.section:recommendation
                            Slice Namerecommendation
                            ShortRecommendations
                            Control0..1
                            108. Composition.section:recommendation.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "18783-1",
                                "display" : "Radiology Study recommendation (narrative)"
                              }]
                            }
                            110. Composition.section:recommendation.entry
                            TypeReference(Care plan: Imaging Report (CZ))
                            112. Composition.section:communication
                            Slice Namecommunication
                            ShortCommunications
                            Control0..1
                            114. Composition.section:communication.extension
                            SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 116. Composition.section:communication.extension:note
                              Slice Namenote
                              Control0..*
                              TypeExtension(Note) (Extension Type: Annotation)
                              118. Composition.section:communication.code
                              Control1..?
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "73575-3",
                                  "display" : "Radiology Consult note"
                                }]
                              }

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

                              0. Composition
                              Definition

                              Imaging Study Report composition.

                              A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.

                              While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

                              The text field of each section SHALL contain a textual representation of all listed entries.

                              ShortImaging Report composition
                              Comments

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

                              Control0..*
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                              dom-6: A resource should have narrative for robust management (text.`div`.exists())
                              text-or-section: A Composition SHALL have either text, at least one section, or both. (text.exists() or section.exists())
                              2. Composition.id
                              Definition

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

                              ShortLogical id of this artifact
                              Comments

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

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

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

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

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

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Composition.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 10. Composition.meta.versionId
                                Definition

                                The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                                ShortVersion specific identifier
                                Comments

                                The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                                Control0..1
                                Typeid
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                12. Composition.meta.lastUpdated
                                Definition

                                When the resource last changed - e.g. when the version changed.

                                ShortWhen the resource version last changed
                                Comments

                                This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                                Control0..1
                                Typeinstant
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                14. Composition.meta.source
                                Definition

                                A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                                ShortIdentifies where the resource comes from
                                Comments

                                In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                                This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                                Control0..1
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                16. Composition.meta.profile
                                Definition

                                A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                                ShortProfiles this resource claims to conform to
                                Comments

                                It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                                Control0..*
                                Typecanonical(StructureDefinition)
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                18. Composition.meta.security
                                Definition

                                Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                                ShortSecurity Labels applied to this resource
                                Comments

                                The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                                Control0..*
                                BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                                (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                                Security Labels from the Healthcare Privacy and Security Classification System.

                                TypeCoding
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                20. Composition.meta.tag
                                Definition

                                Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                                ShortTags applied to this resource
                                Comments

                                The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                                Control0..*
                                BindingFor example codes, see CommonTags
                                (example to http://hl7.org/fhir/ValueSet/common-tags)

                                Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                22. Composition.implicitRules
                                Definition

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

                                ShortA set of rules under which this content was created
                                Comments

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

                                Control0..1
                                Typeuri
                                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                24. Composition.language
                                Definition

                                The base language in which the resource is written.

                                ShortLanguage of the resource content
                                Comments

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

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

                                A human language.

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

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

                                ShortText summary of the resource, for human interpretation
                                Comments

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

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

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

                                ShortContained, inline Resources
                                Comments

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

                                Control0..*
                                TypeResource
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesinline resources, anonymous resources, contained resources
                                30. Composition.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control1..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 32. Composition.extension:diagnosticreport-reference
                                  Slice Namediagnosticreport-reference
                                  Definition

                                  This extension provides a reference to the DiagnosticReport instance that is associated with this Composition.

                                  ShortDocument DiagnosticReport Reference
                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(Diagnostic Report: Imaging Report (CZ)))
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  34. Composition.extension:basedOn-order-or-requisition
                                  Slice NamebasedOn-order-or-requisition
                                  Definition

                                  This extension provides a link to the order [(Reference(ServiceRequest)] or requisition [ServiceRequest.requisition (i.e., 'Request.groupIdentifier')] that this report document is based on and fulfills.

                                  ShortComposition: Based On Order
                                  Control0..*
                                  TypeExtension(Composition: Based On Order) (Extension Type: Choice of: Identifier, Reference(ServiceRequest))
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  36. Composition.extension:basedOn-order-or-requisition.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  38. Composition.extension:basedOn-order-or-requisition.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..0
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Composition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 40. Composition.extension:basedOn-order-or-requisition.url
                                    Definition

                                    Source of the definition for the extension code - a logical name or a URL.

                                    Shortidentifies the meaning of the extension
                                    Comments

                                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                    Control1..1
                                    Typeuri
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    Fixed Valuehttp://hl7.eu/fhir/StructureDefinition/composition-basedOn-order-or-requisition
                                    42. Composition.extension:basedOn-order-or-requisition.value[x]
                                    Definition

                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                    ShortValue of extension
                                    Control0..1
                                    This element is affected by the following invariants: ext-1
                                    TypeChoice of: Identifier, Reference(ServiceRequest)
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on Composition.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 44. Composition.extension:basedOn-order-or-requisition.value[x]:valueReference
                                      Slice NamevalueReference
                                      Definition

                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                      ShortValue of extension
                                      Control0..1
                                      This element is affected by the following invariants: ext-1
                                      TypeReference(Service Request: Imaging Report (CZ))
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      46. Composition.extension:basedOn
                                      Slice NamebasedOn
                                      Definition

                                      A plan, proposal or order that is fulfilled in whole or in part by this event.

                                      ShortFulfills plan, proposal or order
                                      Control0..*
                                      TypeExtension(Based on) (Extension Type: Reference(Resource))
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      48. Composition.extension:informationRecipient
                                      Slice NameinformationRecipient
                                      Definition

                                      This extension applies to the Composition resource and is used to represent an intended recipient of the composition.

                                      ShortComposition: Information recipient
                                      Control0..*
                                      TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      50. Composition.extension:informationRecipient.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      52. Composition.extension:informationRecipient.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..0
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Composition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 54. Composition.extension:informationRecipient.url
                                        Definition

                                        Source of the definition for the extension code - a logical name or a URL.

                                        Shortidentifies the meaning of the extension
                                        Comments

                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                        Control1..1
                                        Typeuri
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        Fixed Valuehttp://hl7.eu/fhir/StructureDefinition/information-recipient
                                        56. Composition.extension:informationRecipient.value[x]
                                        Definition

                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                        ShortValue of extension
                                        Control0..1
                                        This element is affected by the following invariants: ext-1
                                        TypeReference(Practitioner (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Practitioner Role (CZ core), Organization (CZ core))
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        58. Composition.modifierExtension
                                        Definition

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

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

                                        ShortExtensions that cannot be ignored
                                        Comments

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

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

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

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

                                        Identifiers assigned to this Imaging Report by the performer or other systems. It shall be common to several report versions

                                        ShortReport identifier
                                        Comments

                                        Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists

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

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

                                        ShortStatus of the Report
                                        Comments

                                        DiagnosticReport.status and Composition.status shall be aligned

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

                                        The workflow/clinical status of the composition.

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

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

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

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

                                        ShortKind of composition (LOINC if possible)
                                        Comments

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

                                        Control1..1
                                        BindingThe codes SHOULD be taken from FHIRDocumentTypeCodes
                                        (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes)

                                        Type of a composition.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

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

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

                                        ShortCategorization of Composition
                                        Comments

                                        This is a metadata field from XDS/MHD.

                                        Control0..*
                                        BindingFor example codes, see DocumentClassValueSet
                                        (example to http://hl7.org/fhir/ValueSet/document-classcodes)

                                        High-level kind of a clinical document at a macro level.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

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

                                        Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                                        ShortWho and/or what the composition is about
                                        Comments

                                        For clinical documents, this is usually the patient.

                                        Control1..1
                                        TypeReference(Patient (CZ core))
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

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

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

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

                                        ShortContext of the Composition
                                        Control0..1
                                        TypeReference(Encounter)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Provides context for the composition and supports searching.

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

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

                                        ShortDate the report was last changed.
                                        Comments

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

                                        Control1..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

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

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

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

                                        ShortWho and/or what authored the Imaging order
                                        Control1..*
                                        TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Identifies who is responsible for the content.

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

                                        Official human-readable label for the composition.

                                        ShortHuman Readable name/title
                                        Comments

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

                                        Control1..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        78. Composition.confidentiality
                                        Definition

                                        The code specifying the level of confidentiality of the Composition.

                                        ShortAs defined by affinity domain
                                        Comments

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

                                        Control0..1
                                        BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
                                        (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                        Codes specifying the level of confidentiality of the composition.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        80. Composition.attester
                                        Definition

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

                                        ShortAttests to accuracy of composition
                                        Comments

                                        Only list each attester once.

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Identifies responsibility for the accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ mode
                                        • 82. Composition.attester.id
                                          Definition

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

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

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

                                          The type of attestation the authenticator offers.

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

                                          The way in which a person authenticated a composition.

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

                                          Indicates the level of authority of the attestation.

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

                                          When the composition was attested by the party.

                                          ShortWhen the composition was attested
                                          Control0..1
                                          TypedateTime
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

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

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

                                          Who attested the composition in the specified way.

                                          ShortWho attested the composition
                                          Control0..1
                                          TypeReference(Patient (CZ core), Related Person (CZ core), Practitioner (CZ core), Practitioner Role (CZ core), Organization (CZ core))
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

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

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

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

                                          ShortAttests to accuracy of composition
                                          Comments

                                          Only list each attester once.

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Identifies responsibility for the accuracy of the composition content.

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

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

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

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

                                          The type of attestation the authenticator offers.

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

                                          The way in which a person authenticated a composition.

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

                                          Indicates the level of authority of the attestation.

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

                                          When the composition was attested by the party.

                                          ShortWhen the composition was attested
                                          Control0..1
                                          TypedateTime
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

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

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

                                          Who attested the composition in the specified way.

                                          ShortWho attested the composition
                                          Control0..1
                                          TypeReference(Practitioner Role (CZ core))
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

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

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

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

                                          ShortAttests to accuracy of composition
                                          Comments

                                          Only list each attester once.

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Identifies responsibility for the accuracy of the composition content.

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

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

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

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

                                          The type of attestation the authenticator offers.

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

                                          The way in which a person authenticated a composition.

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

                                          Indicates the level of authority of the attestation.

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

                                          When the composition was attested by the party.

                                          ShortWhen the composition was attested
                                          Control0..1
                                          TypedateTime
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

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

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

                                          Who attested the composition in the specified way.

                                          ShortWho attested the composition
                                          Control0..1
                                          TypeReference(Practitioner Role (CZ core))
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

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

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

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

                                          ShortOrganization that manages the Imaging Report
                                          Comments

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

                                          Control0..1
                                          TypeReference(Organization (CZ core))
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

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

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

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

                                          ShortRelationships to other compositions/documents
                                          Comments

                                          A document is a version specific composition.

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

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

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

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

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

                                          Shortreplaces | transforms | signs | appends
                                          Comments

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

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

                                          The type of relationship between documents.

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

                                          The target composition/document of this relationship.

                                          ShortTarget of the relationship
                                          Control1..1
                                          TypeChoice of: Identifier, Reference(Composition)
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          136. Composition.event
                                          Definition

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

                                          ShortThe clinical service(s) being documented
                                          Comments

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

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

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

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

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

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

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

                                          This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

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

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

                                          Control0..*
                                          BindingFor example codes, see ActCode (3.0.0)
                                          (example to http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0)

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

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

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

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

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

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

                                          The root of the sections that make up the composition.

                                          ShortComposition is broken into sections
                                          Control4..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ code
                                          • 152. Composition.section.id
                                            Definition

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

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

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

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

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

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

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

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

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

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

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

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

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

                                            ShortClassification of section (recommended)
                                            Comments

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

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

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

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

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

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

                                            ShortWho and/or what authored the section
                                            Control0..*
                                            TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Identifies who is responsible for the content.

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

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

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

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

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

                                            A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                            ShortText summary of the section, for human interpretation
                                            Comments

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

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

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

                                            Shortworking | snapshot | changes
                                            Comments

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

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

                                            The processing mode that applies to this section.

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

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

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

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

                                            ShortOrder of section entries
                                            Comments

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

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

                                            What order applies to the items in the entry.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

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

                                            ShortA reference to data that supports this section
                                            Comments

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

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

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

                                            ShortWhy the section is empty
                                            Comments

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

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

                                            If a section is empty, why it is empty.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

                                            A nested sub-section within this section.

                                            ShortNested Section
                                            Comments

                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-1
                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            178. Composition.section:imagingstudy
                                            Slice Nameimagingstudy
                                            Definition

                                            This section holds information related to the imaging studies covered by this report.

                                            ShortImaging Study
                                            Control1..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            180. Composition.section:imagingstudy.id
                                            Definition

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

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

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

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

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

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

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

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

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

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

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

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

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

                                            ShortClassification of section (recommended)
                                            Comments

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

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

                                            Control1..1
                                            BindingFor example codes, see DocumentSectionCodes
                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "18726-0",
                                                "display" : "Radiology studies (set)"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            190. Composition.section:imagingstudy.author
                                            Definition

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

                                            ShortWho and/or what authored the section
                                            Control0..*
                                            TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Identifies who is responsible for the content.

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

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

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

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

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

                                            A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                            ShortText summary of the section, for human interpretation
                                            Comments

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

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

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

                                            Shortworking | snapshot | changes
                                            Comments

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

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

                                            The processing mode that applies to this section.

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

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

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

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

                                            ShortOrder of section entries
                                            Comments

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

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

                                            What order applies to the items in the entry.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

                                            This entry holds a reference to the Imaging Study instance that is associated with this Composition.

                                            ShortImaging Study Reference
                                            Comments

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

                                            Control1..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(Imaging Study (CZ))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            202. Composition.section:imagingstudy.emptyReason
                                            Definition

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

                                            ShortWhy the section is empty
                                            Comments

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

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

                                            If a section is empty, why it is empty.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

                                            A nested sub-section within this section.

                                            ShortNested Section
                                            Comments

                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-1
                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            206. Composition.section:order
                                            Slice Nameorder
                                            Definition

                                            This section holds information related to the order for the imaging study.

                                            ShortOrder
                                            Control1..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            208. Composition.section:order.id
                                            Definition

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

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

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

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

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

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

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

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

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

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

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

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

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

                                            ShortClassification of section (recommended)
                                            Comments

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

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

                                            Control1..1
                                            BindingFor example codes, see DocumentSectionCodes
                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "55115-0",
                                                "display" : "Requested imaging studies information Document"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            218. Composition.section:order.author
                                            Definition

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

                                            ShortWho and/or what authored the section
                                            Control0..*
                                            TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Identifies who is responsible for the content.

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

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

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

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

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

                                            A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                            ShortText summary of the section, for human interpretation
                                            Comments

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

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

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

                                            Shortworking | snapshot | changes
                                            Comments

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

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

                                            The processing mode that applies to this section.

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

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

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

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

                                            ShortOrder of section entries
                                            Comments

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

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

                                            What order applies to the items in the entry.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

                                            This entry holds a reference to the order for the Imaging Study and report.

                                            ShortOrder reference
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(Service Request: Imaging Report (CZ))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            230. Composition.section:order.emptyReason
                                            Definition

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

                                            ShortWhy the section is empty
                                            Comments

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

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

                                            If a section is empty, why it is empty.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

                                            A nested sub-section within this section.

                                            ShortNested Section
                                            Comments

                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-1
                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            234. Composition.section:clinicalQuestion
                                            Slice NameclinicalQuestion
                                            Definition

                                            This section holds information about the clinical question that the imaging method is intended to answer.

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

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

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

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

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

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

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

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

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

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

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

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

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

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

                                            ShortClassification of section (recommended)
                                            Comments

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

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

                                            Control1..1
                                            BindingFor example codes, see DocumentSectionCodes
                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "18785-6",
                                                "display" : "Radiology Reason for study (narrative)"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            246. Composition.section:clinicalQuestion.author
                                            Definition

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

                                            ShortWho and/or what authored the section
                                            Control0..*
                                            TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Identifies who is responsible for the content.

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

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

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

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

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

                                            A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                            ShortText summary of the section, for human interpretation
                                            Comments

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

                                            Control1..1
                                            This element is affected by the following invariants: cmp-1
                                            TypeNarrative
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            252. Composition.section:clinicalQuestion.mode
                                            Definition

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

                                            Shortworking | snapshot | changes
                                            Comments

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

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

                                            The processing mode that applies to this section.

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

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

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

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

                                            ShortOrder of section entries
                                            Comments

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

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

                                            What order applies to the items in the entry.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

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

                                            ShortA reference to data that supports this section
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(Condition: Imaging Report (CZ))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            258. Composition.section:clinicalQuestion.emptyReason
                                            Definition

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

                                            ShortWhy the section is empty
                                            Comments

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

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

                                            If a section is empty, why it is empty.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

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

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

                                            A nested sub-section within this section.

                                            ShortNested Section
                                            Comments

                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-1
                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            262. Composition.section:history
                                            Slice Namehistory
                                            Definition

                                            This section includes patient history and other prior clinical details deemed relevant to the imaging study by the imaging clinician.

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

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

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

                                            An Extension

                                            ShortExtension
                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 268. Composition.section:history.extension:note
                                              Slice Namenote
                                              Definition

                                              Additional notes that apply to this resource or element.

                                              ShortAdditional notes that apply to this resource or element.
                                              Comments

                                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                              Control0..*
                                              TypeExtension(Note) (Extension Type: Annotation)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              270. Composition.section:history.modifierExtension
                                              Definition

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

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

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

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

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

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

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

                                              ShortClassification of section (recommended)
                                              Comments

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

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

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "11329-0",
                                                  "display" : "History general Narrative - Reported"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              276. Composition.section:history.author
                                              Definition

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

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

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

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

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

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

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

                                              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                              ShortText summary of the section, for human interpretation
                                              Comments

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

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

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

                                              Shortworking | snapshot | changes
                                              Comments

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

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

                                              The processing mode that applies to this section.

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

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

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

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

                                              ShortOrder of section entries
                                              Comments

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

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

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

                                              ShortA reference to data that supports this section
                                              Comments

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

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

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

                                              ShortWhy the section is empty
                                              Comments

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

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

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              292. Composition.section:procedure
                                              Slice Nameprocedure
                                              Definition

                                              This section contains information such as the procedure type, the anatomy imaged, the date and time of the imaging examination, and the facility that performed it.

                                              ShortProcedure
                                              Control1..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              294. Composition.section:procedure.id
                                              Definition

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

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

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

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

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

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

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

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

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

                                              ShortClassification of section (recommended)
                                              Comments

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

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

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "55111-9",
                                                  "display" : "Current imaging procedure descriptions Document"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              304. Composition.section:procedure.author
                                              Definition

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

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

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

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

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

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

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

                                              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                              ShortText summary of the section, for human interpretation
                                              Comments

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

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

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

                                              Shortworking | snapshot | changes
                                              Comments

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

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

                                              The processing mode that applies to this section.

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

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

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

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

                                              ShortOrder of section entries
                                              Comments

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

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

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

                                              ShortA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Procedure: Imaging Report (CZ))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              316. Composition.section:procedure.emptyReason
                                              Definition

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

                                              ShortWhy the section is empty
                                              Comments

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

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

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              320. Composition.section:comparison
                                              Slice Namecomparison
                                              Definition

                                              The root of the sections that make up the composition.

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

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

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

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

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

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

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

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

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

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

                                              ShortClassification of section (recommended)
                                              Comments

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

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

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "18834-2",
                                                  "display" : "Radiology Comparison study (narrative)"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              332. Composition.section:comparison.author
                                              Definition

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

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

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

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

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

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

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

                                              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                              ShortText summary of the section, for human interpretation
                                              Comments

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

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

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

                                              Shortworking | snapshot | changes
                                              Comments

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

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

                                              The processing mode that applies to this section.

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

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

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

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

                                              ShortOrder of section entries
                                              Comments

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

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

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

                                              ShortA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Imaging Study (CZ))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              344. Composition.section:comparison.emptyReason
                                              Definition

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

                                              ShortWhy the section is empty
                                              Comments

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

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

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              348. Composition.section:findings
                                              Slice Namefindings
                                              Definition

                                              The root of the sections that make up the composition.

                                              ShortFindings
                                              Control1..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              350. Composition.section:findings.id
                                              Definition

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

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

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

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

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

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

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

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

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

                                              ShortClassification of section (recommended)
                                              Comments

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

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

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "59776-5",
                                                  "display" : "Procedure findings Narrative"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              360. Composition.section:findings.author
                                              Definition

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

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

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

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

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

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

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

                                              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                              ShortText summary of the section, for human interpretation
                                              Comments

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

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

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

                                              Shortworking | snapshot | changes
                                              Comments

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

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

                                              The processing mode that applies to this section.

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

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

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

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

                                              ShortOrder of section entries
                                              Comments

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

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

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

                                              ShortA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Observation: Imaging Report (CZ), Imaging Key Image Document Reference: Imaging Report (CZ))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              372. Composition.section:findings.emptyReason
                                              Definition

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

                                              ShortWhy the section is empty
                                              Comments

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

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

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              376. Composition.section:impression
                                              Slice Nameimpression
                                              Definition

                                              The root of the sections that make up the composition.

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

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

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

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

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

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

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

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

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

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

                                              ShortClassification of section (recommended)
                                              Comments

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

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

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "19005-8",
                                                  "display" : "Radiology Imaging study [Impression] (narrative)"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              388. Composition.section:impression.author
                                              Definition

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

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

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

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

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

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

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

                                              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                              ShortText summary of the section, for human interpretation
                                              Comments

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

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

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

                                              Shortworking | snapshot | changes
                                              Comments

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

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

                                              The processing mode that applies to this section.

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

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

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

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

                                              ShortOrder of section entries
                                              Comments

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

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

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

                                              ShortA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Observation: Imaging Report (CZ), Condition: Imaging Report (CZ), Imaging Key Image Document Reference: Imaging Report (CZ))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              400. Composition.section:impression.emptyReason
                                              Definition

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

                                              ShortWhy the section is empty
                                              Comments

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

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

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              404. Composition.section:recommendation
                                              Slice Namerecommendation
                                              Definition

                                              The root of the sections that make up the composition.

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

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

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

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

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

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

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

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

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

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

                                              ShortClassification of section (recommended)
                                              Comments

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

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

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "18783-1",
                                                  "display" : "Radiology Study recommendation (narrative)"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              416. Composition.section:recommendation.author
                                              Definition

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

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

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

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

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

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

                                              Control0..1
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              420. Composition.section:recommendation.text
                                              Definition

                                              A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                              ShortText summary of the section, for human interpretation
                                              Comments

                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                              Control0..1
                                              This element is affected by the following invariants: cmp-1
                                              TypeNarrative
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              422. Composition.section:recommendation.mode
                                              Definition

                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                              Shortworking | snapshot | changes
                                              Comments

                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                              Control0..1
                                              BindingThe codes SHALL be taken from ListMode
                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                              The processing mode that applies to this section.

                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summaryfalse
                                              Requirements

                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              424. Composition.section:recommendation.orderedBy
                                              Definition

                                              Specifies the order applied to the items in the section entries.

                                              ShortOrder of section entries
                                              Comments

                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                              Control0..1
                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                              (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              426. Composition.section:recommendation.entry
                                              Definition

                                              A reference to the actual resource from which the narrative in the section is derived.

                                              ShortA reference to data that supports this section
                                              Comments

                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Care plan: Imaging Report (CZ))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              428. Composition.section:recommendation.emptyReason
                                              Definition

                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                              ShortWhy the section is empty
                                              Comments

                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                              Control0..1
                                              This element is affected by the following invariants: cmp-2
                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              430. Composition.section:recommendation.section
                                              Definition

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              432. Composition.section:communication
                                              Slice Namecommunication
                                              Definition

                                              The root of the sections that make up the composition.

                                              ShortCommunications
                                              Control0..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              434. Composition.section:communication.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              436. Composition.section:communication.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 438. Composition.section:communication.extension:note
                                                Slice Namenote
                                                Definition

                                                Additional notes that apply to this resource or element.

                                                ShortAdditional notes that apply to this resource or element.
                                                Comments

                                                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                Control0..*
                                                TypeExtension(Note) (Extension Type: Annotation)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                440. Composition.section:communication.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                442. Composition.section:communication.title
                                                Definition

                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                ShortLabel for section (e.g. for ToC)
                                                Comments

                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Requirements

                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                Alternate Namesheader, label, caption
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                444. Composition.section:communication.code
                                                Definition

                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                ShortClassification of section (recommended)
                                                Comments

                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                Control1..1
                                                BindingFor example codes, see DocumentSectionCodes
                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                Classification of a section of a composition/document.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Provides computable standardized labels to topics within the document.

                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "73575-3",
                                                    "display" : "Radiology Consult note"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                446. Composition.section:communication.author
                                                Definition

                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                ShortWho and/or what authored the section
                                                Control0..*
                                                TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Device: Performer/Observer (CZ), Patient (CZ core), Related Person (CZ core), Organization (CZ core))
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Identifies who is responsible for the content.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                448. Composition.section:communication.focus
                                                Definition

                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                Comments

                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                Control0..1
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                450. Composition.section:communication.text
                                                Definition

                                                A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                ShortText summary of the section, for human interpretation
                                                Comments

                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                Control0..1
                                                This element is affected by the following invariants: cmp-1
                                                TypeNarrative
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                452. Composition.section:communication.mode
                                                Definition

                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                Shortworking | snapshot | changes
                                                Comments

                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                Control0..1
                                                BindingThe codes SHALL be taken from ListMode
                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                The processing mode that applies to this section.

                                                Typecode
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Requirements

                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                454. Composition.section:communication.orderedBy
                                                Definition

                                                Specifies the order applied to the items in the section entries.

                                                ShortOrder of section entries
                                                Comments

                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                Control0..1
                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                What order applies to the items in the entry.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                456. Composition.section:communication.entry
                                                Definition

                                                A reference to the actual resource from which the narrative in the section is derived.

                                                ShortA reference to data that supports this section
                                                Comments

                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                458. Composition.section:communication.emptyReason
                                                Definition

                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                ShortWhy the section is empty
                                                Comments

                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                Control0..1
                                                This element is affected by the following invariants: cmp-2
                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                If a section is empty, why it is empty.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                460. Composition.section:communication.section
                                                Definition

                                                A nested sub-section within this section.

                                                ShortNested Section
                                                Comments

                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-1
                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))