C-CDA on FHIR
2.0.0-ballot - STU 2 Ballot United States of America flag

C-CDA on FHIR, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ccda-on-fhir/ and changes regularly. See the Directory of published versions

Resource Profile: ConsultationNote - Detailed Descriptions

Active as of 2025-02-12

Definitions for the Consultation-Note resource profile.

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

0. Composition
Definition

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.).

ShortA 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())
2. Composition.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

The base language in which the resource is written.

ShortlanguageLanguage 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).

Control10..1
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
(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
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Composition.extension:versionNumber
Slice NameversionNumber
Definition

Version specific identifier for the composition, assigned when each version is created/updated.

ShortVersion-specific identifier for composition
Comments

While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Composition Version Number) (Extension Type: string)
Is Modifierfalse
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())
8. Composition.extension:version_number_extension
Slice Nameversion_number_extension
Definition

An Extension

ShortExtension
Control0..1
TypeExtension(Version Number) (Extension Type: integer)
Is Modifierfalse
Must Supporttrue
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())
10. Composition.extension:data_enterer_extension
Slice Namedata_enterer_extension
Definition

An Extension

ShortExtension
Control0..1
TypeExtension(Data Enterer Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
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())
12. Composition.extension:informant_extension
Slice Nameinformant_extension
Definition

An Extension

Shortinformant
Control0..*
TypeExtension(Informant Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Labelinformant
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())
14. Composition.extension:information_recipient_extension
Slice Nameinformation_recipient_extension
Definition

An Extension

ShortinformationRecipient
Control0..*
TypeExtension(Information Recipient Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
Summaryfalse
LabelinformationRecipient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Composition.extension:participant_extension
Slice Nameparticipant_extension
Definition

An Extension

Shortparticipant
Control0..*
TypeExtension(Participant Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Labelparticipant
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Composition.extension:performer_extension
Slice Nameperformer_extension
Definition

An Extension

Shortperformer
Control0..*
TypeExtension(Performer Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Labelperformer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Composition.extension:authorization_extension
Slice Nameauthorization_extension
Definition

An Extension

Shortauthorization
Control0..*
TypeExtension(Authorization Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Labelauthorization
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())
22. Composition.extension:order_extension
Slice Nameorder_extension
Definition

An Extension

Shortauthorization
Control0..*
TypeExtension(Order Extension) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Labelauthorization
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())
24. 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.


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())
26. Composition.identifier
Definition

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

ShortidentifierVersion-independent identifier for the Composition
Comments

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

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

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

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

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

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

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

The workflow/clinical status of the composition.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
30. 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.

ShortConsultation NoteKind 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 SHALL be taken from The codes SHOULD be taken from ConsultDocumentTypehttp://hl7.org/fhir/ValueSet/doc-typecodes
(required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.9.31)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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

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

Control0..1
TypeReference(US Core Patient Profile, Group, Resource)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
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()))
34. Composition.encounter
Definition

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

ShortencompassingEncounterContext of the Composition
Control10..1
TypeReference(US Core Encounter Profile, Encounter)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Provides context for the composition and supports searching.

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

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

ShortdateComposition 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()))
38. Composition.author
Definition

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

ShortWho and/or what authored the composition
Control1..*
TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson, Practitioner, Patient, Organization)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
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()))
40. Composition.title
Definition

Official human-readable label for the composition.

ShortDocument TitleHuman Readable name/title
Comments

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

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

Use the confidentiality codes in Meta.security (https://hl7.org/fhir/security-labels.html)


The code specifying the level of confidentiality of the Composition.

ShortUse the confidentiality codes in Meta.securityAs defined by affinity domain
Comments

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

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

Codes specifying the level of confidentiality of the composition.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
LabelUse the confidentiality codes in Meta.security
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. 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 Supportfalse
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
  • 46. Composition.attester.modifierExtension
    Definition

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

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

    The type of attestation the authenticator offers.

    Shortpersonal | professional | legal | official
    Control1..1
    BindingThe codes SHALL be taken from 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()))
    50. Composition.attester:legal_attester
    Slice Namelegal_attester
    Definition

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

    ShortattesterAttests to accuracy of composition
    Comments

    Only list each attester once.

    Control0..1*
    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()))
    52. Composition.attester:legal_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.


    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())
    54. Composition.attester:legal_attester.mode
    Definition

    The type of attestation the authenticator offers.

    Shortmodepersonal | 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.

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

    Who attested the composition in the specified way.

    ShortpartyWho attested the composition
    Control10..1
    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Requirements

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

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

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

    ShortattesterAttests 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()))
    60. Composition.attester:professional_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.


    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())
    62. Composition.attester:professional_attester.mode
    Definition

    The type of attestation the authenticator offers.

    Shortmodepersonal | 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.

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

    Who attested the composition in the specified way.

    ShortpartyWho attested the composition
    Control10..1
    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Requirements

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

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

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

    ShortattesterAttests 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()))
    68. Composition.attester:personal_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.


    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())
    70. Composition.attester:personal_attester.mode
    Definition

    The type of attestation the authenticator offers.

    Shortmodepersonal | 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.

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

    Who attested the composition in the specified way.

    ShortpartyWho attested the composition
    Control10..1
    TypeReference(US Core Patient Profile, RelatedPerson, Patient, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Requirements

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

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

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

    ShortcustodianOrganization which maintains the composition
    Comments

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

    Control10..1
    TypeReference(US Core Organization Profile, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

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

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

    The root of the sections that make up the composition.

    ShortComposition 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())
    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
    • 78. 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.


      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())
      80. Composition.section:allergies_and_intolerances_section
      Slice Nameallergies_and_intolerances_section
      Definition

      The root of the sections that make up the composition.

      ShortAllergies and Intolerances SectionComposition is broken into sections
      Comments

      Allergies and Intolerances Section

      Control10..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      LabelAllergies and Intolerances Section
      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:allergies_and_intolerances_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.


      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:allergies_and_intolerances_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.

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

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

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

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

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

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

      ShortAllergies and adverse reactionsClassification 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
      Must Supporttrue
      Summaryfalse
      Requirements

      Provides computable standardized labels to topics within the document.

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

      ShorttextText 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
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      90. Composition.section:allergies_and_intolerances_section.entry
      Definition

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

      ShortentryA 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()))
      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 92. Composition.section:allergies_and_intolerances_section.entry:allergy_intolerance_entry
        Slice Nameallergy_intolerance_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(US Core AllergyIntolerance Profile, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. Composition.section:history_of_present_illness_section
        Slice Namehistory_of_present_illness_section
        Definition

        The root of the sections that make up the composition.

        ShortHistory of Present Illness SectionComposition is broken into sections
        Comments

        History of Present Illness Section

        Control10..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        LabelHistory of Present Illness Section
        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())
        96. Composition.section:history_of_present_illness_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.


        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())
        98. Composition.section:history_of_present_illness_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.

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

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

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

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

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

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

        ShortHistory of present illnessClassification 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
        Must Supporttrue
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        LabelHistory of present illness
        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "10164-2"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Composition.section:history_of_present_illness_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.

        ShortThis section contains only human readable contentText 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
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Composition.section:problem_section
        Slice Nameproblem_section
        Definition

        The root of the sections that make up the composition.

        ShortProblem SectionComposition is broken into sections
        Comments

        Problem Section

        Control10..1*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        LabelProblem Section
        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())
        106. Composition.section:problem_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.


        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())
        108. Composition.section:problem_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.

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

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

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

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

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

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

        ShortProblem listClassification 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
        Must Supporttrue
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

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

        ShorttextText 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()))
        114. Composition.section:problem_section.entry
        Definition

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

        ShortentryA 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()))
        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 116. Composition.section:problem_section.entry:problem_section_entry
          Slice Nameproblem_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(US Core Condition Profile, Resource)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. Composition.section:medications_section
          Slice Namemedications_section
          Definition

          The root of the sections that make up the composition.

          ShortMedications SectionComposition is broken into sections
          Comments

          Medications Section

          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          LabelMedications Section
          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())
          120. Composition.section:medications_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.


          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())
          122. Composition.section:medications_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.

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

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

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          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()))
          124. Composition.section:medications_section.code
          Definition

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

          ShortHistory of medication useClassification 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.

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

          ShorttextText 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()))
          128. Composition.section:medications_section.entry
          Definition

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

          ShortentryA 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()))
          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • profile @ resolve()
          • 130. Composition.section:medications_section.entry:sliceEntry
            Slice NamesliceEntry
            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(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile, Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. Composition.section:physical_exam_section
            Slice Namephysical_exam_section
            Definition

            The root of the sections that make up the composition.

            ShortPhysical Exam SectionComposition is broken into sections
            Comments

            Physical Exam Section

            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            LabelPhysical Exam Section
            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:physical_exam_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.


            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:physical_exam_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.

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

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

            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            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()))
            138. Composition.section:physical_exam_section.code
            Definition

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

            ShortPhysical findingsClassification 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.

            LabelPhysical findings
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "29545-1"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            140. Composition.section:physical_exam_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.

            ShorttextText 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()))
            142. Composition.section:physical_exam_section.entry
            Definition

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

            ShortentryA 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()))
            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ resolve()
            • 144. Composition.section:physical_exam_section.entry:sliceEntry
              Slice NamesliceEntry
              Definition

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

              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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, Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              146. Composition.section:results_section
              Slice Nameresults_section
              Definition

              The root of the sections that make up the composition.

              ShortResults SectionComposition is broken into sections
              Comments

              Results Section

              Control0..1*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              LabelResults Section
              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())
              148. Composition.section:results_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.


              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())
              150. Composition.section:results_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.

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

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

              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              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()))
              152. Composition.section:results_section.code
              Definition

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

              ShortRelevant diagnostic tests/laboratory dataClassification 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.

              LabelRelevant diagnostic tests/laboratory data
              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "30954-2"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              154. Composition.section:results_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.

              ShorttextText 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()))
              156. Composition.section:results_section.entry
              Definition

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

              ShortentryA 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()))
              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • profile @ resolve()
              • 158. Composition.section:results_section.entry:sliceEntry
                Slice NamesliceEntry
                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(US Core Laboratory Result Observation Profile, Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                160. Composition.section:advance_directives_section
                Slice Nameadvance_directives_section
                Definition

                The root of the sections that make up the composition.

                ShortAdvance Directives SectionComposition is broken into sections
                Comments

                Advance Directives Section

                Control0..1*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                LabelAdvance Directives Section
                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())
                162. Composition.section:advance_directives_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.


                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:advance_directives_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.

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

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

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

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

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

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

                ShortAdvance directivesClassification 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
                Must Supporttrue
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

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

                ShorttextText 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
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                170. Composition.section:advance_directives_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()))
                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ resolve()
                • 172. Composition.section:advance_directives_section.entry:advance_directive_entry
                  Slice Nameadvance_directive_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(Consent, Resource)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  174. Composition.section:assessment_and_plan_section
                  Slice Nameassessment_and_plan_section
                  Definition

                  The root of the sections that make up the composition.

                  ShortAssessment and Plan Section. This section represents the clinician’s conclusions and working assumptions that will guide treatment of the patient. The Assessment and Plan Section may be combined or separated to meet local policy requirements.Composition is broken into sections
                  Comments

                  Assessment and Plan Section

                  Control0..1*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  LabelAssessment and Plan Section
                  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())
                  176. Composition.section:assessment_and_plan_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.


                  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())
                  178. Composition.section:assessment_and_plan_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.

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

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

                  Control10..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  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()))
                  180. Composition.section:assessment_and_plan_section.code
                  Definition

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

                  ShortAssessment (evaluation) and planClassification 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.

                  LabelAssessment (evaluation) and plan
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "51847-2"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  182. Composition.section:assessment_and_plan_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.

                  ShorttextText 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()))
                  184. Composition.section:assessment_and_plan_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()))
                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • profile @ resolve()
                  • 186. Composition.section:assessment_and_plan_section.entry:sliceEntry
                    Slice NamesliceEntry
                    Definition

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

                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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(US Core Condition Profile, Observation, Communication, Resource)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    188. Composition.section:assessment_section
                    Slice Nameassessment_section
                    Definition

                    The root of the sections that make up the composition.

                    ShortAssessment SectionComposition is broken into sections
                    Comments

                    Assessment Section

                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    LabelAssessment Section
                    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())
                    190. Composition.section:assessment_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.


                    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())
                    192. Composition.section:assessment_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.

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

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

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    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()))
                    194. Composition.section:assessment_section.code
                    Definition

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

                    ShortAssessments (evaluation)Classification 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.

                    LabelAssessments (evaluation)
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "51848-0"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    196. Composition.section:assessment_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.

                    ShortThis section contains only human readable contentText 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()))
                    198. Composition.section:chief_complaint_and_reason_for_visit_section
                    Slice Namechief_complaint_and_reason_for_visit_section
                    Definition

                    The root of the sections that make up the composition.

                    ShortChief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.Composition is broken into sections
                    Comments

                    Chief Complaint and Reason for Visit Section

                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    LabelChief Complaint and Reason for Visit Section
                    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())
                    200. Composition.section:chief_complaint_and_reason_for_visit_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.


                    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())
                    202. Composition.section:chief_complaint_and_reason_for_visit_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.

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

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

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    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()))
                    204. Composition.section:chief_complaint_and_reason_for_visit_section.code
                    Definition

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

                    ShortChief complaint and reason for visitClassification 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.

                    LabelChief complaint and reason for visit
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "46239-0"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    206. Composition.section:chief_complaint_and_reason_for_visit_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.

                    ShortThis section contains only human readable contentText 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()))
                    208. Composition.section:chief_complaint_section
                    Slice Namechief_complaint_section
                    Definition

                    The root of the sections that make up the composition.

                    ShortChief Complaint SectionComposition is broken into sections
                    Comments

                    Chief Complaint Section

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


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

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

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

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

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

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

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

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

                    ShortChief complaintClassification 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.

                    LabelChief complaint
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "10154-3"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    216. Composition.section:chief_complaint_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.

                    ShortThis section contains only human readable contentText 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()))
                    218. Composition.section:family_history_section
                    Slice Namefamily_history_section
                    Definition

                    The root of the sections that make up the composition.

                    ShortFamily History SectionComposition is broken into sections
                    Comments

                    Family History Section

                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    LabelFamily History Section
                    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())
                    220. Composition.section:family_history_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.


                    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())
                    222. Composition.section:family_history_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.

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

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

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    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()))
                    224. Composition.section:family_history_section.code
                    Definition

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

                    ShortFamily historyClassification 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.

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

                    ShorttextText 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()))
                    228. Composition.section:family_history_section.entry
                    Definition

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

                    ShortentryA 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()))
                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • profile @ resolve()
                    • 230. Composition.section:family_history_section.entry:sliceEntry
                      Slice NamesliceEntry
                      Definition

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

                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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(FamilyMemberHistory, Resource)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      232. Composition.section:functional_status_section
                      Slice Namefunctional_status_section
                      Definition

                      The root of the sections that make up the composition.

                      ShortFunctional Status SectionComposition is broken into sections
                      Comments

                      Functional Status Section

                      Control0..1*
                      TypeBackboneElement
                      Is Modifierfalse
                      Summaryfalse
                      LabelFunctional Status Section
                      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())
                      234. Composition.section:functional_status_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.


                      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())
                      236. Composition.section:functional_status_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.

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

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

                      Control10..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      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()))
                      238. Composition.section:functional_status_section.code
                      Definition

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

                      ShortFunctional statusClassification 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.

                      LabelFunctional status
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "47420-5"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      240. Composition.section:functional_status_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.

                      ShorttextText 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()))
                      242. Composition.section:functional_status_section.entry
                      Definition

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

                      ShortentryA 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()))
                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ resolve()
                      • 244. Composition.section:functional_status_section.entry:sliceEntry
                        Slice NamesliceEntry
                        Definition

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

                        ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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, Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        246. Composition.section:general_status_section
                        Slice Namegeneral_status_section
                        Definition

                        The root of the sections that make up the composition.

                        ShortGeneral Status SectionComposition is broken into sections
                        Comments

                        General Status Section

                        Control0..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Summaryfalse
                        LabelGeneral Status Section
                        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())
                        248. Composition.section:general_status_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.


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

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

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

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

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

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

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

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

                        ShortPhysical findings of General statusClassification 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.

                        LabelPhysical findings of General status
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "10210-3"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        254. Composition.section:general_status_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.

                        ShortThis section contains only human readable contentText 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()))
                        256. Composition.section:past_medical_history_section
                        Slice Namepast_medical_history_section
                        Definition

                        The root of the sections that make up the composition.

                        ShortPast Medical History SectionComposition is broken into sections
                        Comments

                        Past Medical History Section

                        Control0..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Summaryfalse
                        LabelPast Medical History Section
                        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())
                        258. Composition.section:past_medical_history_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.


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

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

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

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

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

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

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

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

                        ShortPast Medical HistoryClassification 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.

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

                        ShorttextText 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()))
                        266. Composition.section:past_medical_history_section.entry
                        Definition

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

                        ShortentryA 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()))
                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 268. Composition.section:past_medical_history_section.entry:sliceEntry
                          Slice NamesliceEntry
                          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(US Core Condition Profile, Resource)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          270. Composition.section:immunizations_section
                          Slice Nameimmunizations_section
                          Definition

                          The root of the sections that make up the composition.

                          ShortImmunizations SectionComposition is broken into sections
                          Comments

                          Immunizations Section

                          Control0..1*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          LabelImmunizations Section
                          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())
                          272. Composition.section:immunizations_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.


                          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())
                          274. Composition.section:immunizations_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.

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

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

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          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()))
                          276. Composition.section:immunizations_section.code
                          Definition

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

                          ShortHistory of immunizationClassification 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.

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

                          ShorttextText 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()))
                          280. Composition.section:immunizations_section.entry
                          Definition

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

                          ShortentryA 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()))
                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • profile @ resolve()
                          • 282. Composition.section:immunizations_section.entry:sliceEntry
                            Slice NamesliceEntry
                            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(US Core Immunization Profile, Resource)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            284. Composition.section:medical_equipment_section
                            Slice Namemedical_equipment_section
                            Definition

                            The root of the sections that make up the composition.

                            ShortMedical Equipment SectionComposition is broken into sections
                            Comments

                            Medical Equipment Section

                            Control0..1*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            LabelMedical Equipment Section
                            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())
                            286. Composition.section:medical_equipment_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.


                            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())
                            288. Composition.section:medical_equipment_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.

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

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

                            Control10..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            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()))
                            290. Composition.section:medical_equipment_section.code
                            Definition

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

                            ShortHistory of medical device useClassification 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.

                            LabelHistory of medical device use
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "46264-8"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            292. Composition.section:medical_equipment_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.

                            ShorttextText 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()))
                            294. Composition.section:medical_equipment_section.entry
                            Definition

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

                            ShortentryA 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()))
                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • profile @ resolve()
                            • 296. Composition.section:medical_equipment_section.entry:medical_equipment_entry
                              Slice Namemedical_equipment_entry
                              Definition

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

                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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(Device, US Core Procedure Profile, Resource)
                              Is Modifierfalse
                              Must Supporttrue
                              Must Support TypesNo must-support rules about the choice of types/profiles
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              298. Composition.section:mental_status_section
                              Slice Namemental_status_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortMental Status SectionComposition is broken into sections
                              Comments

                              Mental Status Section

                              Control0..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              LabelMental Status Section
                              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())
                              300. Composition.section:mental_status_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.


                              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())
                              302. Composition.section:mental_status_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.

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

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

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              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()))
                              304. Composition.section:mental_status_section.code
                              Definition

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

                              ShortMental statusClassification 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.

                              LabelMental status
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "10190-7"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              306. Composition.section:mental_status_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.

                              ShorttextText 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()))
                              308. Composition.section:mental_status_section.entry
                              Definition

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

                              ShortentryA 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()))
                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • profile @ resolve()
                              • 310. Composition.section:mental_status_section.entry:sliceEntry
                                Slice NamesliceEntry
                                Definition

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

                                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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, Resource)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                312. Composition.section:nutrition_section
                                Slice Namenutrition_section
                                Definition

                                The root of the sections that make up the composition.

                                ShortNutrition SectionComposition is broken into sections
                                Comments

                                Nutrition Section

                                Control0..1*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                LabelNutrition Section
                                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())
                                314. Composition.section:nutrition_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.


                                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())
                                316. Composition.section:nutrition_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.

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

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

                                Control10..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                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()))
                                318. Composition.section:nutrition_section.code
                                Definition

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

                                ShortDiet and nutritionClassification 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.

                                LabelDiet and nutrition
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "61144-2"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                320. Composition.section:nutrition_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.

                                ShorttextText 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()))
                                322. Composition.section:nutrition_section.entry
                                Definition

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

                                ShortentryA 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()))
                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • profile @ resolve()
                                • 324. Composition.section:nutrition_section.entry:sliceEntry
                                  Slice NamesliceEntry
                                  Definition

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

                                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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(NutritionOrder, ClinicalImpression, Resource)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  326. Composition.section:plan_of_treatment_section
                                  Slice Nameplan_of_treatment_section
                                  Definition

                                  The root of the sections that make up the composition.

                                  ShortPlan of Treatment SectionComposition is broken into sections
                                  Comments

                                  Plan of Treatment Section

                                  Control0..1*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summaryfalse
                                  LabelPlan of Treatment Section
                                  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())
                                  328. Composition.section:plan_of_treatment_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.


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

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

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

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

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

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

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

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

                                  ShortPlan of treatmentClassification 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.

                                  LabelPlan of treatment
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "18776-5"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  334. Composition.section:plan_of_treatment_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.

                                  ShorttextText 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()))
                                  336. Composition.section:plan_of_treatment_section.entry
                                  Definition

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

                                  ShortentryA 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()))
                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • profile @ resolve()
                                  • 338. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                    Slice NamesliceEntry
                                    Definition

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

                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A 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(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup, Resource)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    340. Composition.section:procedures_section
                                    Slice Nameprocedures_section
                                    Definition

                                    The root of the sections that make up the composition.

                                    ShortProcedures SectionComposition is broken into sections
                                    Comments

                                    Procedures Section

                                    Control0..1*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Summaryfalse
                                    LabelProcedures Section
                                    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())
                                    342. Composition.section:procedures_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.


                                    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())
                                    344. Composition.section:procedures_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.

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

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

                                    Control10..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    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()))
                                    346. Composition.section:procedures_section.code
                                    Definition

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

                                    ShortHistory of ProceduresClassification 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.

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

                                    ShorttextText 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()))
                                    350. Composition.section:procedures_section.entry
                                    Definition

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

                                    ShortentryA 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()))
                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • profile @ resolve()
                                    • 352. Composition.section:procedures_section.entry:sliceEntry
                                      Slice NamesliceEntry
                                      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(US Core Procedure Profile, Resource)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      354. Composition.section:reason_for_visit_section
                                      Slice Namereason_for_visit_section
                                      Definition

                                      The root of the sections that make up the composition.

                                      ShortReason for Visit SectionComposition is broken into sections
                                      Comments

                                      Reason for Visit Section

                                      Control0..1*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summaryfalse
                                      LabelReason for Visit Section
                                      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())
                                      356. Composition.section:reason_for_visit_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.


                                      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())
                                      358. Composition.section:reason_for_visit_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.

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

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

                                      Control10..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      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()))
                                      360. Composition.section:reason_for_visit_section.code
                                      Definition

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

                                      ShortReason for visitClassification 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.

                                      LabelReason for visit
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "29299-5"
                                        }]
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      362. Composition.section:reason_for_visit_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.

                                      ShortThis section contains only human readable contentText 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()))
                                      364. Composition.section:review_of_systems_section
                                      Slice Namereview_of_systems_section
                                      Definition

                                      The root of the sections that make up the composition.

                                      ShortReview of Systems SectionComposition is broken into sections
                                      Comments

                                      Review of Systems Section

                                      Control0..1*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summaryfalse
                                      LabelReview of Systems Section
                                      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())
                                      366. Composition.section:review_of_systems_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.


                                      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())
                                      368. Composition.section:review_of_systems_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.

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

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

                                      Control10..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      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()))
                                      370. Composition.section:review_of_systems_section.code
                                      Definition

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

                                      ShortReview of systemsClassification 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.

                                      LabelReview of systems
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "10187-3"
                                        }]
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      372. Composition.section:review_of_systems_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.

                                      ShortThis section contains only human readable contentText 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()))
                                      374. Composition.section:social_history_section
                                      Slice Namesocial_history_section
                                      Definition

                                      The root of the sections that make up the composition.

                                      ShortSocial History SectionComposition is broken into sections
                                      Comments

                                      Social History Section

                                      Control0..1*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summaryfalse
                                      LabelSocial History Section
                                      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())
                                      376. Composition.section:social_history_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.


                                      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())
                                      378. Composition.section:social_history_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.

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

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

                                      Control10..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      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()))
                                      380. Composition.section:social_history_section.code
                                      Definition

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

                                      ShortSocial historyClassification 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.

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

                                      ShorttextText 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()))
                                      384. Composition.section:social_history_section.entry
                                      Definition

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

                                      ShortentryA 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()))
                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • profile @ resolve()
                                      • 386. Composition.section:social_history_section.entry:sliceEntry
                                        Slice NamesliceEntry
                                        Definition

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

                                        ShortSmoking statusA 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(US Core Smoking Status Observation Profile, Resource)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        388. Composition.section:vital_signs_section
                                        Slice Namevital_signs_section
                                        Definition

                                        The root of the sections that make up the composition.

                                        ShortVital Signs SectionComposition is broken into sections
                                        Comments

                                        Vital Signs Section

                                        Control0..1*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        LabelVital Signs Section
                                        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())
                                        390. Composition.section:vital_signs_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.


                                        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())
                                        392. Composition.section:vital_signs_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.

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

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

                                        Control10..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        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()))
                                        394. Composition.section:vital_signs_section.code
                                        Definition

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

                                        ShortVital signsClassification 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.

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

                                        ShorttextText 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()))
                                        398. Composition.section:vital_signs_section.entry
                                        Definition

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

                                        ShortentryA 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()))
                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • profile @ resolve()
                                        • 400. Composition.section:vital_signs_section.entry:sliceEntry
                                          Slice NamesliceEntry
                                          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(Vital Signs Profile, Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                                          0. Composition
                                          2. Composition.type
                                          ShortConsultation Note
                                          BindingThe codes SHALL be taken from ConsultDocumentType
                                          (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.9.31)
                                          Must Supporttrue
                                          LabelConsultation Note
                                          4. Composition.encounter
                                          ShortencompassingEncounter
                                          Control1..?
                                          Must Supporttrue
                                          LabelencompassingEncounter
                                          6. Composition.section
                                          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
                                          • 8. Composition.section:allergies_and_intolerances_section
                                            Slice Nameallergies_and_intolerances_section
                                            ShortAllergies and Intolerances Section
                                            Comments

                                            Allergies and Intolerances Section

                                            Control1..1
                                            Must Supporttrue
                                            LabelAllergies and Intolerances Section
                                            10. Composition.section:allergies_and_intolerances_section.title
                                            Shorttitle
                                            Control1..?
                                            Must Supporttrue
                                            12. Composition.section:allergies_and_intolerances_section.code
                                            ShortAllergies and adverse reactions
                                            Control1..?
                                            Must Supporttrue
                                            LabelAllergies and adverse reactions
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "48765-2"
                                              }]
                                            }
                                            14. Composition.section:allergies_and_intolerances_section.text
                                            Shorttext
                                            Control1..?
                                            Must Supporttrue
                                            16. Composition.section:allergies_and_intolerances_section.entry
                                            Shortentry
                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • profile @ resolve()
                                            • 18. Composition.section:allergies_and_intolerances_section.entry:allergy_intolerance_entry
                                              Slice Nameallergy_intolerance_entry
                                              TypeReference(US Core AllergyIntolerance Profile)
                                              Must Supporttrue
                                              20. Composition.section:history_of_present_illness_section
                                              Slice Namehistory_of_present_illness_section
                                              ShortHistory of Present Illness Section
                                              Comments

                                              History of Present Illness Section

                                              Control1..1
                                              Must Supporttrue
                                              LabelHistory of Present Illness Section
                                              22. Composition.section:history_of_present_illness_section.title
                                              Shorttitle
                                              Control1..?
                                              Must Supporttrue
                                              24. Composition.section:history_of_present_illness_section.code
                                              ShortHistory of present illness
                                              Control1..?
                                              Must Supporttrue
                                              LabelHistory of present illness
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "10164-2"
                                                }]
                                              }
                                              26. Composition.section:history_of_present_illness_section.text
                                              ShortThis section contains only human readable content
                                              Control1..?
                                              Must Supporttrue
                                              28. Composition.section:problem_section
                                              Slice Nameproblem_section
                                              ShortProblem Section
                                              Comments

                                              Problem Section

                                              Control1..1
                                              LabelProblem Section
                                              30. Composition.section:problem_section.title
                                              Shorttitle
                                              Control1..?
                                              Must Supporttrue
                                              32. Composition.section:problem_section.code
                                              ShortProblem list
                                              Control1..?
                                              Must Supporttrue
                                              LabelProblem list
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "11450-4"
                                                }]
                                              }
                                              34. Composition.section:problem_section.text
                                              Shorttext
                                              Control1..?
                                              TypeNarrative
                                              36. Composition.section:problem_section.entry
                                              Shortentry
                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ resolve()
                                              • 38. Composition.section:problem_section.entry:problem_section_entry
                                                Slice Nameproblem_section_entry
                                                TypeReference(US Core Condition Profile)
                                                Must Supporttrue
                                                40. Composition.section:medications_section
                                                Slice Namemedications_section
                                                ShortMedications Section
                                                Comments

                                                Medications Section

                                                Control0..1
                                                LabelMedications Section
                                                42. Composition.section:medications_section.title
                                                Shorttitle
                                                Control1..?
                                                44. Composition.section:medications_section.code
                                                ShortHistory of medication use
                                                Control1..?
                                                LabelHistory of medication use
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "10160-0"
                                                  }]
                                                }
                                                46. Composition.section:medications_section.text
                                                Shorttext
                                                Control1..?
                                                48. Composition.section:medications_section.entry
                                                Shortentry
                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • profile @ resolve()
                                                • 50. Composition.section:medications_section.entry:sliceEntry
                                                  Slice NamesliceEntry
                                                  TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile)
                                                  52. Composition.section:physical_exam_section
                                                  Slice Namephysical_exam_section
                                                  ShortPhysical Exam Section
                                                  Comments

                                                  Physical Exam Section

                                                  Control0..1
                                                  LabelPhysical Exam Section
                                                  54. Composition.section:physical_exam_section.title
                                                  Shorttitle
                                                  Control1..?
                                                  56. Composition.section:physical_exam_section.code
                                                  ShortPhysical findings
                                                  Control1..?
                                                  LabelPhysical findings
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "29545-1"
                                                    }]
                                                  }
                                                  58. Composition.section:physical_exam_section.text
                                                  Shorttext
                                                  Control1..?
                                                  60. Composition.section:physical_exam_section.entry
                                                  Shortentry
                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • profile @ resolve()
                                                  • 62. Composition.section:physical_exam_section.entry:sliceEntry
                                                    Slice NamesliceEntry
                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                    TypeReference(Observation)
                                                    64. Composition.section:results_section
                                                    Slice Nameresults_section
                                                    ShortResults Section
                                                    Comments

                                                    Results Section

                                                    Control0..1
                                                    LabelResults Section
                                                    66. Composition.section:results_section.title
                                                    Shorttitle
                                                    Control1..?
                                                    68. Composition.section:results_section.code
                                                    ShortRelevant diagnostic tests/laboratory data
                                                    Control1..?
                                                    LabelRelevant diagnostic tests/laboratory data
                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://loinc.org",
                                                        "code" : "30954-2"
                                                      }]
                                                    }
                                                    70. Composition.section:results_section.text
                                                    Shorttext
                                                    Control1..?
                                                    72. Composition.section:results_section.entry
                                                    Shortentry
                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • profile @ resolve()
                                                    • 74. Composition.section:results_section.entry:sliceEntry
                                                      Slice NamesliceEntry
                                                      TypeReference(US Core Laboratory Result Observation Profile)
                                                      76. Composition.section:advance_directives_section
                                                      Slice Nameadvance_directives_section
                                                      ShortAdvance Directives Section
                                                      Comments

                                                      Advance Directives Section

                                                      Control0..1
                                                      Must Supporttrue
                                                      LabelAdvance Directives Section
                                                      78. Composition.section:advance_directives_section.title
                                                      Shorttitle
                                                      Control1..?
                                                      Must Supporttrue
                                                      80. Composition.section:advance_directives_section.code
                                                      ShortAdvance directives
                                                      Control1..?
                                                      Must Supporttrue
                                                      LabelAdvance directives
                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "42348-3"
                                                        }]
                                                      }
                                                      82. Composition.section:advance_directives_section.text
                                                      Shorttext
                                                      Control1..?
                                                      Must Supporttrue
                                                      84. Composition.section:advance_directives_section.entry
                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • profile @ resolve()
                                                      • 86. Composition.section:advance_directives_section.entry:advance_directive_entry
                                                        Slice Nameadvance_directive_entry
                                                        TypeReference(Consent)
                                                        Must Supporttrue
                                                        88. Composition.section:assessment_and_plan_section
                                                        Slice Nameassessment_and_plan_section
                                                        ShortAssessment and Plan Section. This section represents the clinician’s conclusions and working assumptions that will guide treatment of the patient. The Assessment and Plan Section may be combined or separated to meet local policy requirements.
                                                        Comments

                                                        Assessment and Plan Section

                                                        Control0..1
                                                        LabelAssessment and Plan Section
                                                        90. Composition.section:assessment_and_plan_section.title
                                                        Shorttitle
                                                        Control1..?
                                                        92. Composition.section:assessment_and_plan_section.code
                                                        ShortAssessment (evaluation) and plan
                                                        Control1..?
                                                        LabelAssessment (evaluation) and plan
                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://loinc.org",
                                                            "code" : "51847-2"
                                                          }]
                                                        }
                                                        94. Composition.section:assessment_and_plan_section.text
                                                        Shorttext
                                                        Control1..?
                                                        96. Composition.section:assessment_and_plan_section.entry
                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • profile @ resolve()
                                                        • 98. Composition.section:assessment_and_plan_section.entry:sliceEntry
                                                          Slice NamesliceEntry
                                                          ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                          TypeReference(US Core Condition Profile, Observation, Communication)
                                                          100. Composition.section:assessment_section
                                                          Slice Nameassessment_section
                                                          ShortAssessment Section
                                                          Comments

                                                          Assessment Section

                                                          Control0..1
                                                          LabelAssessment Section
                                                          102. Composition.section:assessment_section.title
                                                          Shorttitle
                                                          Control1..?
                                                          104. Composition.section:assessment_section.code
                                                          ShortAssessments (evaluation)
                                                          Control1..?
                                                          LabelAssessments (evaluation)
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "51848-0"
                                                            }]
                                                          }
                                                          106. Composition.section:assessment_section.text
                                                          ShortThis section contains only human readable content
                                                          Control1..?
                                                          108. Composition.section:chief_complaint_and_reason_for_visit_section
                                                          Slice Namechief_complaint_and_reason_for_visit_section
                                                          ShortChief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.
                                                          Comments

                                                          Chief Complaint and Reason for Visit Section

                                                          Control0..1
                                                          LabelChief Complaint and Reason for Visit Section
                                                          110. Composition.section:chief_complaint_and_reason_for_visit_section.title
                                                          Shorttitle
                                                          Control1..?
                                                          112. Composition.section:chief_complaint_and_reason_for_visit_section.code
                                                          ShortChief complaint and reason for visit
                                                          Control1..?
                                                          LabelChief complaint and reason for visit
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "46239-0"
                                                            }]
                                                          }
                                                          114. Composition.section:chief_complaint_and_reason_for_visit_section.text
                                                          ShortThis section contains only human readable content
                                                          Control1..?
                                                          116. Composition.section:chief_complaint_section
                                                          Slice Namechief_complaint_section
                                                          ShortChief Complaint Section
                                                          Comments

                                                          Chief Complaint Section

                                                          Control0..1
                                                          LabelChief Complaint Section
                                                          118. Composition.section:chief_complaint_section.title
                                                          Shorttitle
                                                          Control1..?
                                                          120. Composition.section:chief_complaint_section.code
                                                          ShortChief complaint
                                                          Control1..?
                                                          LabelChief complaint
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "10154-3"
                                                            }]
                                                          }
                                                          122. Composition.section:chief_complaint_section.text
                                                          ShortThis section contains only human readable content
                                                          Control1..?
                                                          124. Composition.section:family_history_section
                                                          Slice Namefamily_history_section
                                                          ShortFamily History Section
                                                          Comments

                                                          Family History Section

                                                          Control0..1
                                                          LabelFamily History Section
                                                          126. Composition.section:family_history_section.title
                                                          Shorttitle
                                                          Control1..?
                                                          128. Composition.section:family_history_section.code
                                                          ShortFamily history
                                                          Control1..?
                                                          LabelFamily history
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "10157-6"
                                                            }]
                                                          }
                                                          130. Composition.section:family_history_section.text
                                                          Shorttext
                                                          Control1..?
                                                          132. Composition.section:family_history_section.entry
                                                          Shortentry
                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • profile @ resolve()
                                                          • 134. Composition.section:family_history_section.entry:sliceEntry
                                                            Slice NamesliceEntry
                                                            ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                            TypeReference(FamilyMemberHistory)
                                                            136. Composition.section:functional_status_section
                                                            Slice Namefunctional_status_section
                                                            ShortFunctional Status Section
                                                            Comments

                                                            Functional Status Section

                                                            Control0..1
                                                            LabelFunctional Status Section
                                                            138. Composition.section:functional_status_section.title
                                                            Shorttitle
                                                            Control1..?
                                                            140. Composition.section:functional_status_section.code
                                                            ShortFunctional status
                                                            Control1..?
                                                            LabelFunctional status
                                                            Pattern Value{
                                                              "coding" : [{
                                                                "system" : "http://loinc.org",
                                                                "code" : "47420-5"
                                                              }]
                                                            }
                                                            142. Composition.section:functional_status_section.text
                                                            Shorttext
                                                            Control1..?
                                                            144. Composition.section:functional_status_section.entry
                                                            Shortentry
                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • profile @ resolve()
                                                            • 146. Composition.section:functional_status_section.entry:sliceEntry
                                                              Slice NamesliceEntry
                                                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                              TypeReference(Observation)
                                                              148. Composition.section:general_status_section
                                                              Slice Namegeneral_status_section
                                                              ShortGeneral Status Section
                                                              Comments

                                                              General Status Section

                                                              Control0..1
                                                              LabelGeneral Status Section
                                                              150. Composition.section:general_status_section.title
                                                              Shorttitle
                                                              Control1..?
                                                              152. Composition.section:general_status_section.code
                                                              ShortPhysical findings of General status
                                                              Control1..?
                                                              LabelPhysical findings of General status
                                                              Pattern Value{
                                                                "coding" : [{
                                                                  "system" : "http://loinc.org",
                                                                  "code" : "10210-3"
                                                                }]
                                                              }
                                                              154. Composition.section:general_status_section.text
                                                              ShortThis section contains only human readable content
                                                              Control1..?
                                                              156. Composition.section:past_medical_history_section
                                                              Slice Namepast_medical_history_section
                                                              ShortPast Medical History Section
                                                              Comments

                                                              Past Medical History Section

                                                              Control0..1
                                                              LabelPast Medical History Section
                                                              158. Composition.section:past_medical_history_section.title
                                                              Shorttitle
                                                              Control1..?
                                                              160. Composition.section:past_medical_history_section.code
                                                              ShortPast Medical History
                                                              Control1..?
                                                              LabelPast Medical History
                                                              Pattern Value{
                                                                "coding" : [{
                                                                  "system" : "http://loinc.org",
                                                                  "code" : "11348-0"
                                                                }]
                                                              }
                                                              162. Composition.section:past_medical_history_section.text
                                                              Shorttext
                                                              Control1..?
                                                              164. Composition.section:past_medical_history_section.entry
                                                              Shortentry
                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • profile @ resolve()
                                                              • 166. Composition.section:past_medical_history_section.entry:sliceEntry
                                                                Slice NamesliceEntry
                                                                TypeReference(US Core Condition Profile)
                                                                168. Composition.section:immunizations_section
                                                                Slice Nameimmunizations_section
                                                                ShortImmunizations Section
                                                                Comments

                                                                Immunizations Section

                                                                Control0..1
                                                                LabelImmunizations Section
                                                                170. Composition.section:immunizations_section.title
                                                                Shorttitle
                                                                Control1..?
                                                                172. Composition.section:immunizations_section.code
                                                                ShortHistory of immunization
                                                                Control1..?
                                                                LabelHistory of immunization
                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://loinc.org",
                                                                    "code" : "11369-6"
                                                                  }]
                                                                }
                                                                174. Composition.section:immunizations_section.text
                                                                Shorttext
                                                                Control1..?
                                                                176. Composition.section:immunizations_section.entry
                                                                Shortentry
                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • profile @ resolve()
                                                                • 178. Composition.section:immunizations_section.entry:sliceEntry
                                                                  Slice NamesliceEntry
                                                                  TypeReference(US Core Immunization Profile)
                                                                  180. Composition.section:medical_equipment_section
                                                                  Slice Namemedical_equipment_section
                                                                  ShortMedical Equipment Section
                                                                  Comments

                                                                  Medical Equipment Section

                                                                  Control0..1
                                                                  LabelMedical Equipment Section
                                                                  182. Composition.section:medical_equipment_section.title
                                                                  Shorttitle
                                                                  Control1..?
                                                                  184. Composition.section:medical_equipment_section.code
                                                                  ShortHistory of medical device use
                                                                  Control1..?
                                                                  LabelHistory of medical device use
                                                                  Pattern Value{
                                                                    "coding" : [{
                                                                      "system" : "http://loinc.org",
                                                                      "code" : "46264-8"
                                                                    }]
                                                                  }
                                                                  186. Composition.section:medical_equipment_section.text
                                                                  Shorttext
                                                                  Control1..?
                                                                  188. Composition.section:medical_equipment_section.entry
                                                                  Shortentry
                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • profile @ resolve()
                                                                  • 190. Composition.section:medical_equipment_section.entry:medical_equipment_entry
                                                                    Slice Namemedical_equipment_entry
                                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                    TypeReference(Device, US Core Procedure Profile)
                                                                    Must Supporttrue
                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                    192. Composition.section:mental_status_section
                                                                    Slice Namemental_status_section
                                                                    ShortMental Status Section
                                                                    Comments

                                                                    Mental Status Section

                                                                    Control0..1
                                                                    LabelMental Status Section
                                                                    194. Composition.section:mental_status_section.title
                                                                    Shorttitle
                                                                    Control1..?
                                                                    196. Composition.section:mental_status_section.code
                                                                    ShortMental status
                                                                    Control1..?
                                                                    LabelMental status
                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://loinc.org",
                                                                        "code" : "10190-7"
                                                                      }]
                                                                    }
                                                                    198. Composition.section:mental_status_section.text
                                                                    Shorttext
                                                                    Control1..?
                                                                    200. Composition.section:mental_status_section.entry
                                                                    Shortentry
                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • profile @ resolve()
                                                                    • 202. Composition.section:mental_status_section.entry:sliceEntry
                                                                      Slice NamesliceEntry
                                                                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                      TypeReference(Observation)
                                                                      204. Composition.section:nutrition_section
                                                                      Slice Namenutrition_section
                                                                      ShortNutrition Section
                                                                      Comments

                                                                      Nutrition Section

                                                                      Control0..1
                                                                      LabelNutrition Section
                                                                      206. Composition.section:nutrition_section.title
                                                                      Shorttitle
                                                                      Control1..?
                                                                      208. Composition.section:nutrition_section.code
                                                                      ShortDiet and nutrition
                                                                      Control1..?
                                                                      LabelDiet and nutrition
                                                                      Pattern Value{
                                                                        "coding" : [{
                                                                          "system" : "http://loinc.org",
                                                                          "code" : "61144-2"
                                                                        }]
                                                                      }
                                                                      210. Composition.section:nutrition_section.text
                                                                      Shorttext
                                                                      Control1..?
                                                                      212. Composition.section:nutrition_section.entry
                                                                      Shortentry
                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • profile @ resolve()
                                                                      • 214. Composition.section:nutrition_section.entry:sliceEntry
                                                                        Slice NamesliceEntry
                                                                        ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                        TypeReference(NutritionOrder, ClinicalImpression)
                                                                        216. Composition.section:plan_of_treatment_section
                                                                        Slice Nameplan_of_treatment_section
                                                                        ShortPlan of Treatment Section
                                                                        Comments

                                                                        Plan of Treatment Section

                                                                        Control0..1
                                                                        LabelPlan of Treatment Section
                                                                        218. Composition.section:plan_of_treatment_section.title
                                                                        Shorttitle
                                                                        Control1..?
                                                                        220. Composition.section:plan_of_treatment_section.code
                                                                        ShortPlan of treatment
                                                                        Control1..?
                                                                        LabelPlan of treatment
                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://loinc.org",
                                                                            "code" : "18776-5"
                                                                          }]
                                                                        }
                                                                        222. Composition.section:plan_of_treatment_section.text
                                                                        Shorttext
                                                                        Control1..?
                                                                        224. Composition.section:plan_of_treatment_section.entry
                                                                        Shortentry
                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • profile @ resolve()
                                                                        • 226. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                                                          Slice NamesliceEntry
                                                                          ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                          TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                                                                          228. Composition.section:procedures_section
                                                                          Slice Nameprocedures_section
                                                                          ShortProcedures Section
                                                                          Comments

                                                                          Procedures Section

                                                                          Control0..1
                                                                          LabelProcedures Section
                                                                          230. Composition.section:procedures_section.title
                                                                          Shorttitle
                                                                          Control1..?
                                                                          232. Composition.section:procedures_section.code
                                                                          ShortHistory of Procedures
                                                                          Control1..?
                                                                          LabelHistory of Procedures
                                                                          Pattern Value{
                                                                            "coding" : [{
                                                                              "system" : "http://loinc.org",
                                                                              "code" : "47519-4"
                                                                            }]
                                                                          }
                                                                          234. Composition.section:procedures_section.text
                                                                          Shorttext
                                                                          Control1..?
                                                                          236. Composition.section:procedures_section.entry
                                                                          Shortentry
                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • profile @ resolve()
                                                                          • 238. Composition.section:procedures_section.entry:sliceEntry
                                                                            Slice NamesliceEntry
                                                                            TypeReference(US Core Procedure Profile)
                                                                            240. Composition.section:reason_for_visit_section
                                                                            Slice Namereason_for_visit_section
                                                                            ShortReason for Visit Section
                                                                            Comments

                                                                            Reason for Visit Section

                                                                            Control0..1
                                                                            LabelReason for Visit Section
                                                                            242. Composition.section:reason_for_visit_section.title
                                                                            Shorttitle
                                                                            Control1..?
                                                                            244. Composition.section:reason_for_visit_section.code
                                                                            ShortReason for visit
                                                                            Control1..?
                                                                            LabelReason for visit
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "29299-5"
                                                                              }]
                                                                            }
                                                                            246. Composition.section:reason_for_visit_section.text
                                                                            ShortThis section contains only human readable content
                                                                            Control1..?
                                                                            248. Composition.section:review_of_systems_section
                                                                            Slice Namereview_of_systems_section
                                                                            ShortReview of Systems Section
                                                                            Comments

                                                                            Review of Systems Section

                                                                            Control0..1
                                                                            LabelReview of Systems Section
                                                                            250. Composition.section:review_of_systems_section.title
                                                                            Shorttitle
                                                                            Control1..?
                                                                            252. Composition.section:review_of_systems_section.code
                                                                            ShortReview of systems
                                                                            Control1..?
                                                                            LabelReview of systems
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "10187-3"
                                                                              }]
                                                                            }
                                                                            254. Composition.section:review_of_systems_section.text
                                                                            ShortThis section contains only human readable content
                                                                            Control1..?
                                                                            256. Composition.section:social_history_section
                                                                            Slice Namesocial_history_section
                                                                            ShortSocial History Section
                                                                            Comments

                                                                            Social History Section

                                                                            Control0..1
                                                                            LabelSocial History Section
                                                                            258. Composition.section:social_history_section.title
                                                                            Shorttitle
                                                                            Control1..?
                                                                            260. Composition.section:social_history_section.code
                                                                            ShortSocial history
                                                                            Control1..?
                                                                            LabelSocial history
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "29762-2"
                                                                              }]
                                                                            }
                                                                            262. Composition.section:social_history_section.text
                                                                            Shorttext
                                                                            Control1..?
                                                                            264. Composition.section:social_history_section.entry
                                                                            Shortentry
                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • profile @ resolve()
                                                                            • 266. Composition.section:social_history_section.entry:sliceEntry
                                                                              Slice NamesliceEntry
                                                                              ShortSmoking status
                                                                              TypeReference(US Core Smoking Status Observation Profile)
                                                                              268. Composition.section:vital_signs_section
                                                                              Slice Namevital_signs_section
                                                                              ShortVital Signs Section
                                                                              Comments

                                                                              Vital Signs Section

                                                                              Control0..1
                                                                              LabelVital Signs Section
                                                                              270. Composition.section:vital_signs_section.title
                                                                              Shorttitle
                                                                              Control1..?
                                                                              272. Composition.section:vital_signs_section.code
                                                                              ShortVital signs
                                                                              Control1..?
                                                                              LabelVital signs
                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "http://loinc.org",
                                                                                  "code" : "8716-3"
                                                                                }]
                                                                              }
                                                                              274. Composition.section:vital_signs_section.text
                                                                              Shorttext
                                                                              Control1..?
                                                                              276. Composition.section:vital_signs_section.entry
                                                                              Shortentry
                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • profile @ resolve()
                                                                              • 278. Composition.section:vital_signs_section.entry:sliceEntry
                                                                                Slice NamesliceEntry
                                                                                TypeReference(Vital Signs Profile)

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

                                                                                0. Composition
                                                                                Definition

                                                                                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.).

                                                                                ShortA 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())
                                                                                2. Composition.id
                                                                                Definition

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

                                                                                ShortLogical id of this artifact
                                                                                Comments

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

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

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

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

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

                                                                                ShortA set of rules under which this content was created
                                                                                Comments

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

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

                                                                                The base language in which the resource is written.

                                                                                Shortlanguage
                                                                                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).

                                                                                Control1..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
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                10. Composition.text
                                                                                Definition

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

                                                                                ShortText summary of the resource, for human interpretation
                                                                                Comments

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

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

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

                                                                                ShortContained, inline Resources
                                                                                Comments

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

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

                                                                                An Extension

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

                                                                                  Version specific identifier for the composition, assigned when each version is created/updated.

                                                                                  ShortVersion-specific identifier for composition
                                                                                  Comments

                                                                                  While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(Composition Version Number) (Extension Type: string)
                                                                                  Is Modifierfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  18. Composition.extension:version_number_extension
                                                                                  Slice Nameversion_number_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..1
                                                                                  TypeExtension(Version Number) (Extension Type: integer)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  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())
                                                                                  20. Composition.extension:data_enterer_extension
                                                                                  Slice Namedata_enterer_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..1
                                                                                  TypeExtension(Data Enterer Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  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())
                                                                                  22. Composition.extension:informant_extension
                                                                                  Slice Nameinformant_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortinformant
                                                                                  Control0..*
                                                                                  TypeExtension(Informant Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelinformant
                                                                                  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())
                                                                                  24. Composition.extension:information_recipient_extension
                                                                                  Slice Nameinformation_recipient_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortinformationRecipient
                                                                                  Control0..*
                                                                                  TypeExtension(Information Recipient Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  LabelinformationRecipient
                                                                                  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())
                                                                                  26. Composition.extension:participant_extension
                                                                                  Slice Nameparticipant_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortparticipant
                                                                                  Control0..*
                                                                                  TypeExtension(Participant Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelparticipant
                                                                                  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())
                                                                                  28. Composition.extension:performer_extension
                                                                                  Slice Nameperformer_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortperformer
                                                                                  Control0..*
                                                                                  TypeExtension(Performer Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelperformer
                                                                                  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())
                                                                                  30. Composition.extension:authorization_extension
                                                                                  Slice Nameauthorization_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortauthorization
                                                                                  Control0..*
                                                                                  TypeExtension(Authorization Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelauthorization
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  32. Composition.extension:order_extension
                                                                                  Slice Nameorder_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortauthorization
                                                                                  Control0..*
                                                                                  TypeExtension(Order Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelauthorization
                                                                                  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.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())
                                                                                  36. Composition.identifier
                                                                                  Definition

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

                                                                                  Shortidentifier
                                                                                  Comments

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

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

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

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

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

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

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

                                                                                  The workflow/clinical status of the composition.

                                                                                  Typecode
                                                                                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  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()))
                                                                                  40. 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.

                                                                                  ShortConsultation Note
                                                                                  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 SHALL be taken from ConsultDocumentType
                                                                                  (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.9.31)
                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

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

                                                                                  LabelConsultation Note
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  42. 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()))
                                                                                  44. 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.

                                                                                  Control0..1
                                                                                  TypeReference(US Core Patient Profile, Group)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                  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()))
                                                                                  46. Composition.encounter
                                                                                  Definition

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

                                                                                  ShortencompassingEncounter
                                                                                  Control1..1
                                                                                  TypeReference(US Core Encounter Profile)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Provides context for the composition and supports searching.

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

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

                                                                                  Shortdate
                                                                                  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()))
                                                                                  50. Composition.author
                                                                                  Definition

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

                                                                                  ShortWho and/or what authored the composition
                                                                                  Control1..*
                                                                                  TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                  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()))
                                                                                  52. Composition.title
                                                                                  Definition

                                                                                  Official human-readable label for the composition.

                                                                                  ShortDocument Title
                                                                                  Comments

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

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

                                                                                  Use the confidentiality codes in Meta.security (https://hl7.org/fhir/security-labels.html)

                                                                                  ShortUse the confidentiality codes in Meta.security
                                                                                  Comments

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

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

                                                                                  Codes specifying the level of confidentiality of the composition.

                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supportfalse
                                                                                  Summarytrue
                                                                                  LabelUse the confidentiality codes in Meta.security
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  56. 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 Supportfalse
                                                                                  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
                                                                                  • 58. 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
                                                                                    60. 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())
                                                                                    62. 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())
                                                                                    64. 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()))
                                                                                    66. 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()))
                                                                                    68. Composition.attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    ShortWho attested the composition
                                                                                    Control0..1
                                                                                    TypeReference(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()))
                                                                                    70. Composition.attester:legal_attester
                                                                                    Slice Namelegal_attester
                                                                                    Definition

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

                                                                                    Shortattester
                                                                                    Comments

                                                                                    Only list each attester once.

                                                                                    Control0..1
                                                                                    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()))
                                                                                    72. Composition.attester:legal_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
                                                                                    74. Composition.attester:legal_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())
                                                                                    76. Composition.attester:legal_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())
                                                                                    78. Composition.attester:legal_attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortmode
                                                                                    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.

                                                                                    Fixed Valuelegal
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    80. Composition.attester:legal_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()))
                                                                                    82. Composition.attester:legal_attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    Shortparty
                                                                                    Control1..1
                                                                                    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Requirements

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

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

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

                                                                                    Shortattester
                                                                                    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()))
                                                                                    86. Composition.attester:professional_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
                                                                                    88. Composition.attester:professional_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())
                                                                                    90. Composition.attester:professional_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())
                                                                                    92. Composition.attester:professional_attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortmode
                                                                                    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.

                                                                                    Fixed Valueprofessional
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    94. Composition.attester:professional_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()))
                                                                                    96. Composition.attester:professional_attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    Shortparty
                                                                                    Control1..1
                                                                                    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Requirements

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

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

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

                                                                                    Shortattester
                                                                                    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()))
                                                                                    100. Composition.attester:personal_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
                                                                                    102. Composition.attester:personal_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())
                                                                                    104. Composition.attester:personal_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())
                                                                                    106. Composition.attester:personal_attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortmode
                                                                                    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.

                                                                                    Fixed Valuepersonal
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    108. Composition.attester:personal_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()))
                                                                                    110. Composition.attester:personal_attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    Shortparty
                                                                                    Control1..1
                                                                                    TypeReference(US Core Patient Profile, RelatedPerson)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Requirements

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

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

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

                                                                                    Shortcustodian
                                                                                    Comments

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

                                                                                    Control1..1
                                                                                    TypeReference(US Core Organization Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

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

                                                                                    Labelcustodian
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    114. 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()))
                                                                                    116. 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
                                                                                    118. 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())
                                                                                    120. 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())
                                                                                    122. 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()))
                                                                                    124. 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()))
                                                                                    126. 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()))
                                                                                    128. 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
                                                                                    130. 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())
                                                                                    132. 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())
                                                                                    134. Composition.event.code
                                                                                    Definition

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

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

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

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

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

                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    136. 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()))
                                                                                    138. 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()))
                                                                                    140. Composition.section
                                                                                    Definition

                                                                                    The root of the sections that make up the composition.

                                                                                    ShortComposition 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()))
                                                                                    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
                                                                                    • 142. 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
                                                                                      144. 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())
                                                                                      146. 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())
                                                                                      148. 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()))
                                                                                      150. 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()))
                                                                                      152. Composition.section.author
                                                                                      Definition

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

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

                                                                                      Identifies who is responsible for the content.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      154. 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()))
                                                                                      156. 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()))
                                                                                      158. 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()))
                                                                                      160. 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()))
                                                                                      162. 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()))
                                                                                      164. 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()))
                                                                                      166. 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()))
                                                                                      168. Composition.section:allergies_and_intolerances_section
                                                                                      Slice Nameallergies_and_intolerances_section
                                                                                      Definition

                                                                                      The root of the sections that make up the composition.

                                                                                      ShortAllergies and Intolerances Section
                                                                                      Comments

                                                                                      Allergies and Intolerances Section

                                                                                      Control1..1
                                                                                      TypeBackboneElement
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      LabelAllergies and Intolerances Section
                                                                                      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()))
                                                                                      170. Composition.section:allergies_and_intolerances_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
                                                                                      172. Composition.section:allergies_and_intolerances_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())
                                                                                      174. Composition.section:allergies_and_intolerances_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())
                                                                                      176. Composition.section:allergies_and_intolerances_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.

                                                                                      Shorttitle
                                                                                      Comments

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

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

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

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

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

                                                                                      ShortAllergies and adverse reactions
                                                                                      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
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Provides computable standardized labels to topics within the document.

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

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

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

                                                                                      Identifies who is responsible for the content.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      182. Composition.section:allergies_and_intolerances_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()))
                                                                                      184. Composition.section:allergies_and_intolerances_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
                                                                                      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
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      186. Composition.section:allergies_and_intolerances_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()))
                                                                                      188. Composition.section:allergies_and_intolerances_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()))
                                                                                      190. Composition.section:allergies_and_intolerances_section.entry
                                                                                      Definition

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

                                                                                      Shortentry
                                                                                      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()))
                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • profile @ resolve()
                                                                                      • 192. Composition.section:allergies_and_intolerances_section.entry:allergy_intolerance_entry
                                                                                        Slice Nameallergy_intolerance_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(US Core AllergyIntolerance Profile)
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        194. Composition.section:allergies_and_intolerances_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()))
                                                                                        196. Composition.section:allergies_and_intolerances_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()))
                                                                                        198. Composition.section:history_of_present_illness_section
                                                                                        Slice Namehistory_of_present_illness_section
                                                                                        Definition

                                                                                        The root of the sections that make up the composition.

                                                                                        ShortHistory of Present Illness Section
                                                                                        Comments

                                                                                        History of Present Illness Section

                                                                                        Control1..1
                                                                                        TypeBackboneElement
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        LabelHistory of Present Illness Section
                                                                                        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()))
                                                                                        200. Composition.section:history_of_present_illness_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
                                                                                        202. Composition.section:history_of_present_illness_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())
                                                                                        204. Composition.section:history_of_present_illness_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())
                                                                                        206. Composition.section:history_of_present_illness_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.

                                                                                        Shorttitle
                                                                                        Comments

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

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

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

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

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

                                                                                        ShortHistory of present illness
                                                                                        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
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Provides computable standardized labels to topics within the document.

                                                                                        LabelHistory of present illness
                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://loinc.org",
                                                                                            "code" : "10164-2"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        210. Composition.section:history_of_present_illness_section.author
                                                                                        Definition

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

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

                                                                                        Identifies who is responsible for the content.

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

                                                                                        ShortThis section contains only human readable content
                                                                                        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
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        216. Composition.section:history_of_present_illness_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()))
                                                                                        218. Composition.section:history_of_present_illness_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()))
                                                                                        220. Composition.section:history_of_present_illness_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()))
                                                                                        222. Composition.section:history_of_present_illness_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()))
                                                                                        224. Composition.section:history_of_present_illness_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()))
                                                                                        226. Composition.section:problem_section
                                                                                        Slice Nameproblem_section
                                                                                        Definition

                                                                                        The root of the sections that make up the composition.

                                                                                        ShortProblem Section
                                                                                        Comments

                                                                                        Problem Section

                                                                                        Control1..1
                                                                                        TypeBackboneElement
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        LabelProblem Section
                                                                                        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()))
                                                                                        228. Composition.section:problem_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
                                                                                        230. Composition.section:problem_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())
                                                                                        232. Composition.section:problem_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())
                                                                                        234. Composition.section:problem_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.

                                                                                        Shorttitle
                                                                                        Comments

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

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

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

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

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

                                                                                        ShortProblem list
                                                                                        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
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Provides computable standardized labels to topics within the document.

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

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

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

                                                                                        Identifies who is responsible for the content.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        240. Composition.section:problem_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()))
                                                                                        242. Composition.section:problem_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
                                                                                        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()))
                                                                                        244. Composition.section:problem_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()))
                                                                                        246. Composition.section:problem_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()))
                                                                                        248. Composition.section:problem_section.entry
                                                                                        Definition

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

                                                                                        Shortentry
                                                                                        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()))
                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • profile @ resolve()
                                                                                        • 250. Composition.section:problem_section.entry:problem_section_entry
                                                                                          Slice Nameproblem_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(US Core Condition Profile)
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          252. Composition.section:problem_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()))
                                                                                          254. Composition.section:problem_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()))
                                                                                          256. Composition.section:medications_section
                                                                                          Slice Namemedications_section
                                                                                          Definition

                                                                                          The root of the sections that make up the composition.

                                                                                          ShortMedications Section
                                                                                          Comments

                                                                                          Medications Section

                                                                                          Control0..1
                                                                                          TypeBackboneElement
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          LabelMedications Section
                                                                                          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()))
                                                                                          258. Composition.section:medications_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
                                                                                          260. Composition.section:medications_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())
                                                                                          262. Composition.section:medications_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())
                                                                                          264. Composition.section:medications_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.

                                                                                          Shorttitle
                                                                                          Comments

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

                                                                                          Control1..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          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()))
                                                                                          266. Composition.section:medications_section.code
                                                                                          Definition

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

                                                                                          ShortHistory of medication use
                                                                                          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.

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

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

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

                                                                                          Identifies who is responsible for the content.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          270. Composition.section:medications_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()))
                                                                                          272. Composition.section:medications_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
                                                                                          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()))
                                                                                          274. Composition.section:medications_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()))
                                                                                          276. Composition.section:medications_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()))
                                                                                          278. Composition.section:medications_section.entry
                                                                                          Definition

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

                                                                                          Shortentry
                                                                                          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()))
                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • profile @ resolve()
                                                                                          • 280. Composition.section:medications_section.entry:sliceEntry
                                                                                            Slice NamesliceEntry
                                                                                            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(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            282. Composition.section:medications_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()))
                                                                                            284. Composition.section:medications_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()))
                                                                                            286. Composition.section:physical_exam_section
                                                                                            Slice Namephysical_exam_section
                                                                                            Definition

                                                                                            The root of the sections that make up the composition.

                                                                                            ShortPhysical Exam Section
                                                                                            Comments

                                                                                            Physical Exam Section

                                                                                            Control0..1
                                                                                            TypeBackboneElement
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            LabelPhysical Exam Section
                                                                                            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()))
                                                                                            288. Composition.section:physical_exam_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
                                                                                            290. Composition.section:physical_exam_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())
                                                                                            292. Composition.section:physical_exam_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())
                                                                                            294. Composition.section:physical_exam_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.

                                                                                            Shorttitle
                                                                                            Comments

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

                                                                                            Control1..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            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()))
                                                                                            296. Composition.section:physical_exam_section.code
                                                                                            Definition

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

                                                                                            ShortPhysical findings
                                                                                            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.

                                                                                            LabelPhysical findings
                                                                                            Pattern Value{
                                                                                              "coding" : [{
                                                                                                "system" : "http://loinc.org",
                                                                                                "code" : "29545-1"
                                                                                              }]
                                                                                            }
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            298. Composition.section:physical_exam_section.author
                                                                                            Definition

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

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

                                                                                            Identifies who is responsible for the content.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            300. Composition.section:physical_exam_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()))
                                                                                            302. Composition.section:physical_exam_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
                                                                                            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()))
                                                                                            304. Composition.section:physical_exam_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()))
                                                                                            306. Composition.section:physical_exam_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()))
                                                                                            308. Composition.section:physical_exam_section.entry
                                                                                            Definition

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

                                                                                            Shortentry
                                                                                            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()))
                                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • profile @ resolve()
                                                                                            • 310. Composition.section:physical_exam_section.entry:sliceEntry
                                                                                              Slice NamesliceEntry
                                                                                              Definition

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

                                                                                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                              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)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              312. Composition.section:physical_exam_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()))
                                                                                              314. Composition.section:physical_exam_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()))
                                                                                              316. Composition.section:results_section
                                                                                              Slice Nameresults_section
                                                                                              Definition

                                                                                              The root of the sections that make up the composition.

                                                                                              ShortResults Section
                                                                                              Comments

                                                                                              Results Section

                                                                                              Control0..1
                                                                                              TypeBackboneElement
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              LabelResults Section
                                                                                              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()))
                                                                                              318. Composition.section:results_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
                                                                                              320. Composition.section:results_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())
                                                                                              322. Composition.section:results_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())
                                                                                              324. Composition.section:results_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.

                                                                                              Shorttitle
                                                                                              Comments

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

                                                                                              Control1..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              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()))
                                                                                              326. Composition.section:results_section.code
                                                                                              Definition

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

                                                                                              ShortRelevant diagnostic tests/laboratory data
                                                                                              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.

                                                                                              LabelRelevant diagnostic tests/laboratory data
                                                                                              Pattern Value{
                                                                                                "coding" : [{
                                                                                                  "system" : "http://loinc.org",
                                                                                                  "code" : "30954-2"
                                                                                                }]
                                                                                              }
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              328. Composition.section:results_section.author
                                                                                              Definition

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

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

                                                                                              Identifies who is responsible for the content.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              330. Composition.section:results_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()))
                                                                                              332. Composition.section:results_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
                                                                                              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()))
                                                                                              334. Composition.section:results_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()))
                                                                                              336. Composition.section:results_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()))
                                                                                              338. Composition.section:results_section.entry
                                                                                              Definition

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

                                                                                              Shortentry
                                                                                              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()))
                                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • profile @ resolve()
                                                                                              • 340. Composition.section:results_section.entry:sliceEntry
                                                                                                Slice NamesliceEntry
                                                                                                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(US Core Laboratory Result Observation Profile)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                342. Composition.section:results_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()))
                                                                                                344. Composition.section:results_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()))
                                                                                                346. Composition.section:advance_directives_section
                                                                                                Slice Nameadvance_directives_section
                                                                                                Definition

                                                                                                The root of the sections that make up the composition.

                                                                                                ShortAdvance Directives Section
                                                                                                Comments

                                                                                                Advance Directives Section

                                                                                                Control0..1
                                                                                                TypeBackboneElement
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                LabelAdvance Directives Section
                                                                                                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()))
                                                                                                348. Composition.section:advance_directives_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
                                                                                                350. Composition.section:advance_directives_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())
                                                                                                352. Composition.section:advance_directives_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())
                                                                                                354. Composition.section:advance_directives_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.

                                                                                                Shorttitle
                                                                                                Comments

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

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

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

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

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

                                                                                                ShortAdvance directives
                                                                                                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
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Provides computable standardized labels to topics within the document.

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

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

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

                                                                                                Identifies who is responsible for the content.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                360. Composition.section:advance_directives_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()))
                                                                                                362. Composition.section:advance_directives_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
                                                                                                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
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                364. Composition.section:advance_directives_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()))
                                                                                                366. Composition.section:advance_directives_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()))
                                                                                                368. Composition.section:advance_directives_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()))
                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • profile @ resolve()
                                                                                                • 370. Composition.section:advance_directives_section.entry:advance_directive_entry
                                                                                                  Slice Nameadvance_directive_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(Consent)
                                                                                                  Is Modifierfalse
                                                                                                  Must Supporttrue
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  372. Composition.section:advance_directives_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()))
                                                                                                  374. Composition.section:advance_directives_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()))
                                                                                                  376. Composition.section:assessment_and_plan_section
                                                                                                  Slice Nameassessment_and_plan_section
                                                                                                  Definition

                                                                                                  The root of the sections that make up the composition.

                                                                                                  ShortAssessment and Plan Section. This section represents the clinician’s conclusions and working assumptions that will guide treatment of the patient. The Assessment and Plan Section may be combined or separated to meet local policy requirements.
                                                                                                  Comments

                                                                                                  Assessment and Plan Section

                                                                                                  Control0..1
                                                                                                  TypeBackboneElement
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  LabelAssessment and Plan Section
                                                                                                  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:assessment_and_plan_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
                                                                                                  380. Composition.section:assessment_and_plan_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())
                                                                                                  382. Composition.section:assessment_and_plan_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())
                                                                                                  384. Composition.section:assessment_and_plan_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.

                                                                                                  Shorttitle
                                                                                                  Comments

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

                                                                                                  Control1..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  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:assessment_and_plan_section.code
                                                                                                  Definition

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

                                                                                                  ShortAssessment (evaluation) and plan
                                                                                                  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.

                                                                                                  LabelAssessment (evaluation) and plan
                                                                                                  Pattern Value{
                                                                                                    "coding" : [{
                                                                                                      "system" : "http://loinc.org",
                                                                                                      "code" : "51847-2"
                                                                                                    }]
                                                                                                  }
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  388. Composition.section:assessment_and_plan_section.author
                                                                                                  Definition

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

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

                                                                                                  Identifies who is responsible for the content.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  390. Composition.section:assessment_and_plan_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()))
                                                                                                  392. Composition.section:assessment_and_plan_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
                                                                                                  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()))
                                                                                                  394. Composition.section:assessment_and_plan_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()))
                                                                                                  396. Composition.section:assessment_and_plan_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()))
                                                                                                  398. Composition.section:assessment_and_plan_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()))
                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • profile @ resolve()
                                                                                                  • 400. Composition.section:assessment_and_plan_section.entry:sliceEntry
                                                                                                    Slice NamesliceEntry
                                                                                                    Definition

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

                                                                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                    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(US Core Condition Profile, Observation, Communication)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    402. Composition.section:assessment_and_plan_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()))
                                                                                                    404. Composition.section:assessment_and_plan_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()))
                                                                                                    406. Composition.section:assessment_section
                                                                                                    Slice Nameassessment_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortAssessment Section
                                                                                                    Comments

                                                                                                    Assessment Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelAssessment Section
                                                                                                    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()))
                                                                                                    408. Composition.section:assessment_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
                                                                                                    410. Composition.section:assessment_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())
                                                                                                    412. Composition.section:assessment_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())
                                                                                                    414. Composition.section:assessment_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.

                                                                                                    Shorttitle
                                                                                                    Comments

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

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    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()))
                                                                                                    416. Composition.section:assessment_section.code
                                                                                                    Definition

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

                                                                                                    ShortAssessments (evaluation)
                                                                                                    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.

                                                                                                    LabelAssessments (evaluation)
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "51848-0"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    418. Composition.section:assessment_section.author
                                                                                                    Definition

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

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

                                                                                                    Identifies who is responsible for the content.

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

                                                                                                    ShortThis section contains only human readable content
                                                                                                    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()))
                                                                                                    424. Composition.section:assessment_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()))
                                                                                                    426. Composition.section:assessment_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()))
                                                                                                    428. Composition.section:assessment_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()))
                                                                                                    430. Composition.section:assessment_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()))
                                                                                                    432. Composition.section:assessment_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()))
                                                                                                    434. Composition.section:chief_complaint_and_reason_for_visit_section
                                                                                                    Slice Namechief_complaint_and_reason_for_visit_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortChief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.
                                                                                                    Comments

                                                                                                    Chief Complaint and Reason for Visit Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelChief Complaint and Reason for Visit Section
                                                                                                    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()))
                                                                                                    436. Composition.section:chief_complaint_and_reason_for_visit_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
                                                                                                    438. Composition.section:chief_complaint_and_reason_for_visit_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())
                                                                                                    440. Composition.section:chief_complaint_and_reason_for_visit_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())
                                                                                                    442. Composition.section:chief_complaint_and_reason_for_visit_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.

                                                                                                    Shorttitle
                                                                                                    Comments

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

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    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:chief_complaint_and_reason_for_visit_section.code
                                                                                                    Definition

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

                                                                                                    ShortChief complaint and reason for visit
                                                                                                    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.

                                                                                                    LabelChief complaint and reason for visit
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "46239-0"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    446. Composition.section:chief_complaint_and_reason_for_visit_section.author
                                                                                                    Definition

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

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

                                                                                                    Identifies who is responsible for the content.

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

                                                                                                    ShortThis section contains only human readable content
                                                                                                    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()))
                                                                                                    452. Composition.section:chief_complaint_and_reason_for_visit_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()))
                                                                                                    454. Composition.section:chief_complaint_and_reason_for_visit_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()))
                                                                                                    456. Composition.section:chief_complaint_and_reason_for_visit_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()))
                                                                                                    458. Composition.section:chief_complaint_and_reason_for_visit_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()))
                                                                                                    460. Composition.section:chief_complaint_and_reason_for_visit_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()))
                                                                                                    462. Composition.section:chief_complaint_section
                                                                                                    Slice Namechief_complaint_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortChief Complaint Section
                                                                                                    Comments

                                                                                                    Chief Complaint Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelChief Complaint Section
                                                                                                    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()))
                                                                                                    464. Composition.section:chief_complaint_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
                                                                                                    466. Composition.section:chief_complaint_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())
                                                                                                    468. Composition.section:chief_complaint_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())
                                                                                                    470. Composition.section:chief_complaint_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.

                                                                                                    Shorttitle
                                                                                                    Comments

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

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    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()))
                                                                                                    472. Composition.section:chief_complaint_section.code
                                                                                                    Definition

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

                                                                                                    ShortChief complaint
                                                                                                    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.

                                                                                                    LabelChief complaint
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "10154-3"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    474. Composition.section:chief_complaint_section.author
                                                                                                    Definition

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

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

                                                                                                    Identifies who is responsible for the content.

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

                                                                                                    ShortThis section contains only human readable content
                                                                                                    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()))
                                                                                                    480. Composition.section:chief_complaint_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()))
                                                                                                    482. Composition.section:chief_complaint_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()))
                                                                                                    484. Composition.section:chief_complaint_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()))
                                                                                                    486. Composition.section:chief_complaint_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()))
                                                                                                    488. Composition.section:chief_complaint_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()))
                                                                                                    490. Composition.section:family_history_section
                                                                                                    Slice Namefamily_history_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortFamily History Section
                                                                                                    Comments

                                                                                                    Family History Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelFamily History Section
                                                                                                    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()))
                                                                                                    492. Composition.section:family_history_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
                                                                                                    494. Composition.section:family_history_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())
                                                                                                    496. Composition.section:family_history_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())
                                                                                                    498. Composition.section:family_history_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.

                                                                                                    Shorttitle
                                                                                                    Comments

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

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    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()))
                                                                                                    500. Composition.section:family_history_section.code
                                                                                                    Definition

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

                                                                                                    ShortFamily history
                                                                                                    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.

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

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

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

                                                                                                    Identifies who is responsible for the content.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    504. Composition.section:family_history_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()))
                                                                                                    506. Composition.section:family_history_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
                                                                                                    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()))
                                                                                                    508. Composition.section:family_history_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()))
                                                                                                    510. Composition.section:family_history_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()))
                                                                                                    512. Composition.section:family_history_section.entry
                                                                                                    Definition

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

                                                                                                    Shortentry
                                                                                                    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()))
                                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • profile @ resolve()
                                                                                                    • 514. Composition.section:family_history_section.entry:sliceEntry
                                                                                                      Slice NamesliceEntry
                                                                                                      Definition

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

                                                                                                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                      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(FamilyMemberHistory)
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      516. Composition.section:family_history_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()))
                                                                                                      518. Composition.section:family_history_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()))
                                                                                                      520. Composition.section:functional_status_section
                                                                                                      Slice Namefunctional_status_section
                                                                                                      Definition

                                                                                                      The root of the sections that make up the composition.

                                                                                                      ShortFunctional Status Section
                                                                                                      Comments

                                                                                                      Functional Status Section

                                                                                                      Control0..1
                                                                                                      TypeBackboneElement
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      LabelFunctional Status Section
                                                                                                      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()))
                                                                                                      522. Composition.section:functional_status_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
                                                                                                      524. Composition.section:functional_status_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())
                                                                                                      526. Composition.section:functional_status_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())
                                                                                                      528. Composition.section:functional_status_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.

                                                                                                      Shorttitle
                                                                                                      Comments

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

                                                                                                      Control1..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      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()))
                                                                                                      530. Composition.section:functional_status_section.code
                                                                                                      Definition

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

                                                                                                      ShortFunctional status
                                                                                                      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.

                                                                                                      LabelFunctional status
                                                                                                      Pattern Value{
                                                                                                        "coding" : [{
                                                                                                          "system" : "http://loinc.org",
                                                                                                          "code" : "47420-5"
                                                                                                        }]
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      532. Composition.section:functional_status_section.author
                                                                                                      Definition

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

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

                                                                                                      Identifies who is responsible for the content.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      534. Composition.section:functional_status_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()))
                                                                                                      536. Composition.section:functional_status_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
                                                                                                      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()))
                                                                                                      538. Composition.section:functional_status_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()))
                                                                                                      540. Composition.section:functional_status_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()))
                                                                                                      542. Composition.section:functional_status_section.entry
                                                                                                      Definition

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

                                                                                                      Shortentry
                                                                                                      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()))
                                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • profile @ resolve()
                                                                                                      • 544. Composition.section:functional_status_section.entry:sliceEntry
                                                                                                        Slice NamesliceEntry
                                                                                                        Definition

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

                                                                                                        ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                        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)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        546. Composition.section:functional_status_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()))
                                                                                                        548. Composition.section:functional_status_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()))
                                                                                                        550. Composition.section:general_status_section
                                                                                                        Slice Namegeneral_status_section
                                                                                                        Definition

                                                                                                        The root of the sections that make up the composition.

                                                                                                        ShortGeneral Status Section
                                                                                                        Comments

                                                                                                        General Status Section

                                                                                                        Control0..1
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        LabelGeneral Status Section
                                                                                                        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()))
                                                                                                        552. Composition.section:general_status_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
                                                                                                        554. Composition.section:general_status_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())
                                                                                                        556. Composition.section:general_status_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())
                                                                                                        558. Composition.section:general_status_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.

                                                                                                        Shorttitle
                                                                                                        Comments

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

                                                                                                        Control1..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        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()))
                                                                                                        560. Composition.section:general_status_section.code
                                                                                                        Definition

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

                                                                                                        ShortPhysical findings of General status
                                                                                                        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.

                                                                                                        LabelPhysical findings of General status
                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://loinc.org",
                                                                                                            "code" : "10210-3"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        562. Composition.section:general_status_section.author
                                                                                                        Definition

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

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

                                                                                                        Identifies who is responsible for the content.

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

                                                                                                        ShortThis section contains only human readable content
                                                                                                        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()))
                                                                                                        568. Composition.section:general_status_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()))
                                                                                                        570. Composition.section:general_status_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()))
                                                                                                        572. Composition.section:general_status_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()))
                                                                                                        574. Composition.section:general_status_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()))
                                                                                                        576. Composition.section:general_status_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()))
                                                                                                        578. Composition.section:past_medical_history_section
                                                                                                        Slice Namepast_medical_history_section
                                                                                                        Definition

                                                                                                        The root of the sections that make up the composition.

                                                                                                        ShortPast Medical History Section
                                                                                                        Comments

                                                                                                        Past Medical History Section

                                                                                                        Control0..1
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        LabelPast Medical History Section
                                                                                                        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()))
                                                                                                        580. Composition.section:past_medical_history_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
                                                                                                        582. Composition.section:past_medical_history_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())
                                                                                                        584. Composition.section:past_medical_history_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())
                                                                                                        586. Composition.section:past_medical_history_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.

                                                                                                        Shorttitle
                                                                                                        Comments

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

                                                                                                        Control1..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        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()))
                                                                                                        588. Composition.section:past_medical_history_section.code
                                                                                                        Definition

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

                                                                                                        ShortPast Medical History
                                                                                                        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.

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

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

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

                                                                                                        Identifies who is responsible for the content.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        592. Composition.section:past_medical_history_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()))
                                                                                                        594. Composition.section:past_medical_history_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
                                                                                                        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()))
                                                                                                        596. Composition.section:past_medical_history_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()))
                                                                                                        598. Composition.section:past_medical_history_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()))
                                                                                                        600. Composition.section:past_medical_history_section.entry
                                                                                                        Definition

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

                                                                                                        Shortentry
                                                                                                        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()))
                                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • profile @ resolve()
                                                                                                        • 602. Composition.section:past_medical_history_section.entry:sliceEntry
                                                                                                          Slice NamesliceEntry
                                                                                                          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(US Core Condition Profile)
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          604. Composition.section:past_medical_history_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()))
                                                                                                          606. Composition.section:past_medical_history_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()))
                                                                                                          608. Composition.section:immunizations_section
                                                                                                          Slice Nameimmunizations_section
                                                                                                          Definition

                                                                                                          The root of the sections that make up the composition.

                                                                                                          ShortImmunizations Section
                                                                                                          Comments

                                                                                                          Immunizations Section

                                                                                                          Control0..1
                                                                                                          TypeBackboneElement
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          LabelImmunizations Section
                                                                                                          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()))
                                                                                                          610. Composition.section:immunizations_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
                                                                                                          612. Composition.section:immunizations_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())
                                                                                                          614. Composition.section:immunizations_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())
                                                                                                          616. Composition.section:immunizations_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.

                                                                                                          Shorttitle
                                                                                                          Comments

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

                                                                                                          Control1..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          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()))
                                                                                                          618. Composition.section:immunizations_section.code
                                                                                                          Definition

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

                                                                                                          ShortHistory of immunization
                                                                                                          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.

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

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

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

                                                                                                          Identifies who is responsible for the content.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          622. Composition.section:immunizations_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()))
                                                                                                          624. Composition.section:immunizations_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
                                                                                                          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()))
                                                                                                          626. Composition.section:immunizations_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()))
                                                                                                          628. Composition.section:immunizations_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()))
                                                                                                          630. Composition.section:immunizations_section.entry
                                                                                                          Definition

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

                                                                                                          Shortentry
                                                                                                          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()))
                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • profile @ resolve()
                                                                                                          • 632. Composition.section:immunizations_section.entry:sliceEntry
                                                                                                            Slice NamesliceEntry
                                                                                                            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(US Core Immunization Profile)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            634. Composition.section:immunizations_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()))
                                                                                                            636. Composition.section:immunizations_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()))
                                                                                                            638. Composition.section:medical_equipment_section
                                                                                                            Slice Namemedical_equipment_section
                                                                                                            Definition

                                                                                                            The root of the sections that make up the composition.

                                                                                                            ShortMedical Equipment Section
                                                                                                            Comments

                                                                                                            Medical Equipment Section

                                                                                                            Control0..1
                                                                                                            TypeBackboneElement
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            LabelMedical Equipment Section
                                                                                                            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()))
                                                                                                            640. Composition.section:medical_equipment_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
                                                                                                            642. Composition.section:medical_equipment_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())
                                                                                                            644. Composition.section:medical_equipment_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())
                                                                                                            646. Composition.section:medical_equipment_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.

                                                                                                            Shorttitle
                                                                                                            Comments

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

                                                                                                            Control1..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            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()))
                                                                                                            648. Composition.section:medical_equipment_section.code
                                                                                                            Definition

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

                                                                                                            ShortHistory of medical device use
                                                                                                            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.

                                                                                                            LabelHistory of medical device use
                                                                                                            Pattern Value{
                                                                                                              "coding" : [{
                                                                                                                "system" : "http://loinc.org",
                                                                                                                "code" : "46264-8"
                                                                                                              }]
                                                                                                            }
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            650. Composition.section:medical_equipment_section.author
                                                                                                            Definition

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

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

                                                                                                            Identifies who is responsible for the content.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            652. Composition.section:medical_equipment_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()))
                                                                                                            654. Composition.section:medical_equipment_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
                                                                                                            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()))
                                                                                                            656. Composition.section:medical_equipment_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()))
                                                                                                            658. Composition.section:medical_equipment_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()))
                                                                                                            660. Composition.section:medical_equipment_section.entry
                                                                                                            Definition

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

                                                                                                            Shortentry
                                                                                                            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()))
                                                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • profile @ resolve()
                                                                                                            • 662. Composition.section:medical_equipment_section.entry:medical_equipment_entry
                                                                                                              Slice Namemedical_equipment_entry
                                                                                                              Definition

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

                                                                                                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                              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(Device, US Core Procedure Profile)
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              664. Composition.section:medical_equipment_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()))
                                                                                                              666. Composition.section:medical_equipment_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()))
                                                                                                              668. Composition.section:mental_status_section
                                                                                                              Slice Namemental_status_section
                                                                                                              Definition

                                                                                                              The root of the sections that make up the composition.

                                                                                                              ShortMental Status Section
                                                                                                              Comments

                                                                                                              Mental Status Section

                                                                                                              Control0..1
                                                                                                              TypeBackboneElement
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              LabelMental Status Section
                                                                                                              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()))
                                                                                                              670. Composition.section:mental_status_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
                                                                                                              672. Composition.section:mental_status_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())
                                                                                                              674. Composition.section:mental_status_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())
                                                                                                              676. Composition.section:mental_status_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.

                                                                                                              Shorttitle
                                                                                                              Comments

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

                                                                                                              Control1..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              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()))
                                                                                                              678. Composition.section:mental_status_section.code
                                                                                                              Definition

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

                                                                                                              ShortMental status
                                                                                                              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.

                                                                                                              LabelMental status
                                                                                                              Pattern Value{
                                                                                                                "coding" : [{
                                                                                                                  "system" : "http://loinc.org",
                                                                                                                  "code" : "10190-7"
                                                                                                                }]
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              680. Composition.section:mental_status_section.author
                                                                                                              Definition

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

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

                                                                                                              Identifies who is responsible for the content.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              682. Composition.section:mental_status_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()))
                                                                                                              684. Composition.section:mental_status_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
                                                                                                              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()))
                                                                                                              686. Composition.section:mental_status_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()))
                                                                                                              688. Composition.section:mental_status_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()))
                                                                                                              690. Composition.section:mental_status_section.entry
                                                                                                              Definition

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

                                                                                                              Shortentry
                                                                                                              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()))
                                                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • profile @ resolve()
                                                                                                              • 692. Composition.section:mental_status_section.entry:sliceEntry
                                                                                                                Slice NamesliceEntry
                                                                                                                Definition

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

                                                                                                                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                                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)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                694. Composition.section:mental_status_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()))
                                                                                                                696. Composition.section:mental_status_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()))
                                                                                                                698. Composition.section:nutrition_section
                                                                                                                Slice Namenutrition_section
                                                                                                                Definition

                                                                                                                The root of the sections that make up the composition.

                                                                                                                ShortNutrition Section
                                                                                                                Comments

                                                                                                                Nutrition Section

                                                                                                                Control0..1
                                                                                                                TypeBackboneElement
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                LabelNutrition Section
                                                                                                                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()))
                                                                                                                700. Composition.section:nutrition_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
                                                                                                                702. Composition.section:nutrition_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())
                                                                                                                704. Composition.section:nutrition_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())
                                                                                                                706. Composition.section:nutrition_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.

                                                                                                                Shorttitle
                                                                                                                Comments

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

                                                                                                                Control1..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                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()))
                                                                                                                708. Composition.section:nutrition_section.code
                                                                                                                Definition

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

                                                                                                                ShortDiet and nutrition
                                                                                                                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.

                                                                                                                LabelDiet and nutrition
                                                                                                                Pattern Value{
                                                                                                                  "coding" : [{
                                                                                                                    "system" : "http://loinc.org",
                                                                                                                    "code" : "61144-2"
                                                                                                                  }]
                                                                                                                }
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                710. Composition.section:nutrition_section.author
                                                                                                                Definition

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

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

                                                                                                                Identifies who is responsible for the content.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                712. Composition.section:nutrition_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()))
                                                                                                                714. Composition.section:nutrition_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
                                                                                                                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()))
                                                                                                                716. Composition.section:nutrition_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()))
                                                                                                                718. Composition.section:nutrition_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()))
                                                                                                                720. Composition.section:nutrition_section.entry
                                                                                                                Definition

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

                                                                                                                Shortentry
                                                                                                                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()))
                                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • profile @ resolve()
                                                                                                                • 722. Composition.section:nutrition_section.entry:sliceEntry
                                                                                                                  Slice NamesliceEntry
                                                                                                                  Definition

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

                                                                                                                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                                  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(NutritionOrder, ClinicalImpression)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  724. Composition.section:nutrition_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()))
                                                                                                                  726. Composition.section:nutrition_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()))
                                                                                                                  728. Composition.section:plan_of_treatment_section
                                                                                                                  Slice Nameplan_of_treatment_section
                                                                                                                  Definition

                                                                                                                  The root of the sections that make up the composition.

                                                                                                                  ShortPlan of Treatment Section
                                                                                                                  Comments

                                                                                                                  Plan of Treatment Section

                                                                                                                  Control0..1
                                                                                                                  TypeBackboneElement
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  LabelPlan of Treatment Section
                                                                                                                  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()))
                                                                                                                  730. Composition.section:plan_of_treatment_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
                                                                                                                  732. Composition.section:plan_of_treatment_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())
                                                                                                                  734. Composition.section:plan_of_treatment_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())
                                                                                                                  736. Composition.section:plan_of_treatment_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.

                                                                                                                  Shorttitle
                                                                                                                  Comments

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

                                                                                                                  Control1..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  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()))
                                                                                                                  738. Composition.section:plan_of_treatment_section.code
                                                                                                                  Definition

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

                                                                                                                  ShortPlan of treatment
                                                                                                                  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.

                                                                                                                  LabelPlan of treatment
                                                                                                                  Pattern Value{
                                                                                                                    "coding" : [{
                                                                                                                      "system" : "http://loinc.org",
                                                                                                                      "code" : "18776-5"
                                                                                                                    }]
                                                                                                                  }
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  740. Composition.section:plan_of_treatment_section.author
                                                                                                                  Definition

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

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

                                                                                                                  Identifies who is responsible for the content.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  742. Composition.section:plan_of_treatment_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()))
                                                                                                                  744. Composition.section:plan_of_treatment_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
                                                                                                                  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()))
                                                                                                                  746. Composition.section:plan_of_treatment_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()))
                                                                                                                  748. Composition.section:plan_of_treatment_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()))
                                                                                                                  750. Composition.section:plan_of_treatment_section.entry
                                                                                                                  Definition

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

                                                                                                                  Shortentry
                                                                                                                  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()))
                                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • profile @ resolve()
                                                                                                                  • 752. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                                                                                                    Slice NamesliceEntry
                                                                                                                    Definition

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

                                                                                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                                    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(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    754. Composition.section:plan_of_treatment_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()))
                                                                                                                    756. Composition.section:plan_of_treatment_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()))
                                                                                                                    758. Composition.section:procedures_section
                                                                                                                    Slice Nameprocedures_section
                                                                                                                    Definition

                                                                                                                    The root of the sections that make up the composition.

                                                                                                                    ShortProcedures Section
                                                                                                                    Comments

                                                                                                                    Procedures Section

                                                                                                                    Control0..1
                                                                                                                    TypeBackboneElement
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    LabelProcedures Section
                                                                                                                    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()))
                                                                                                                    760. Composition.section:procedures_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
                                                                                                                    762. Composition.section:procedures_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())
                                                                                                                    764. Composition.section:procedures_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())
                                                                                                                    766. Composition.section:procedures_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.

                                                                                                                    Shorttitle
                                                                                                                    Comments

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

                                                                                                                    Control1..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    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()))
                                                                                                                    768. Composition.section:procedures_section.code
                                                                                                                    Definition

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

                                                                                                                    ShortHistory of Procedures
                                                                                                                    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.

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

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

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

                                                                                                                    Identifies who is responsible for the content.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    772. Composition.section:procedures_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()))
                                                                                                                    774. Composition.section:procedures_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
                                                                                                                    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()))
                                                                                                                    776. Composition.section:procedures_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()))
                                                                                                                    778. Composition.section:procedures_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()))
                                                                                                                    780. Composition.section:procedures_section.entry
                                                                                                                    Definition

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

                                                                                                                    Shortentry
                                                                                                                    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()))
                                                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • profile @ resolve()
                                                                                                                    • 782. Composition.section:procedures_section.entry:sliceEntry
                                                                                                                      Slice NamesliceEntry
                                                                                                                      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(US Core Procedure Profile)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      784. Composition.section:procedures_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()))
                                                                                                                      786. Composition.section:procedures_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()))
                                                                                                                      788. Composition.section:reason_for_visit_section
                                                                                                                      Slice Namereason_for_visit_section
                                                                                                                      Definition

                                                                                                                      The root of the sections that make up the composition.

                                                                                                                      ShortReason for Visit Section
                                                                                                                      Comments

                                                                                                                      Reason for Visit Section

                                                                                                                      Control0..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      LabelReason for Visit Section
                                                                                                                      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()))
                                                                                                                      790. Composition.section:reason_for_visit_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
                                                                                                                      792. Composition.section:reason_for_visit_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())
                                                                                                                      794. Composition.section:reason_for_visit_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())
                                                                                                                      796. Composition.section:reason_for_visit_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.

                                                                                                                      Shorttitle
                                                                                                                      Comments

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

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      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()))
                                                                                                                      798. Composition.section:reason_for_visit_section.code
                                                                                                                      Definition

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

                                                                                                                      ShortReason for visit
                                                                                                                      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.

                                                                                                                      LabelReason for visit
                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "29299-5"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      800. Composition.section:reason_for_visit_section.author
                                                                                                                      Definition

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

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

                                                                                                                      Identifies who is responsible for the content.

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

                                                                                                                      ShortThis section contains only human readable content
                                                                                                                      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()))
                                                                                                                      806. Composition.section:reason_for_visit_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()))
                                                                                                                      808. Composition.section:reason_for_visit_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()))
                                                                                                                      810. Composition.section:reason_for_visit_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()))
                                                                                                                      812. Composition.section:reason_for_visit_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()))
                                                                                                                      814. Composition.section:reason_for_visit_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()))
                                                                                                                      816. Composition.section:review_of_systems_section
                                                                                                                      Slice Namereview_of_systems_section
                                                                                                                      Definition

                                                                                                                      The root of the sections that make up the composition.

                                                                                                                      ShortReview of Systems Section
                                                                                                                      Comments

                                                                                                                      Review of Systems Section

                                                                                                                      Control0..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      LabelReview of Systems Section
                                                                                                                      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()))
                                                                                                                      818. Composition.section:review_of_systems_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
                                                                                                                      820. Composition.section:review_of_systems_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())
                                                                                                                      822. Composition.section:review_of_systems_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())
                                                                                                                      824. Composition.section:review_of_systems_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.

                                                                                                                      Shorttitle
                                                                                                                      Comments

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

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      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()))
                                                                                                                      826. Composition.section:review_of_systems_section.code
                                                                                                                      Definition

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

                                                                                                                      ShortReview of systems
                                                                                                                      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.

                                                                                                                      LabelReview of systems
                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "10187-3"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      828. Composition.section:review_of_systems_section.author
                                                                                                                      Definition

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

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

                                                                                                                      Identifies who is responsible for the content.

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

                                                                                                                      ShortThis section contains only human readable content
                                                                                                                      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()))
                                                                                                                      834. Composition.section:review_of_systems_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()))
                                                                                                                      836. Composition.section:review_of_systems_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()))
                                                                                                                      838. Composition.section:review_of_systems_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()))
                                                                                                                      840. Composition.section:review_of_systems_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()))
                                                                                                                      842. Composition.section:review_of_systems_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()))
                                                                                                                      844. Composition.section:social_history_section
                                                                                                                      Slice Namesocial_history_section
                                                                                                                      Definition

                                                                                                                      The root of the sections that make up the composition.

                                                                                                                      ShortSocial History Section
                                                                                                                      Comments

                                                                                                                      Social History Section

                                                                                                                      Control0..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      LabelSocial History Section
                                                                                                                      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()))
                                                                                                                      846. Composition.section:social_history_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
                                                                                                                      848. Composition.section:social_history_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())
                                                                                                                      850. Composition.section:social_history_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())
                                                                                                                      852. Composition.section:social_history_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.

                                                                                                                      Shorttitle
                                                                                                                      Comments

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

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      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()))
                                                                                                                      854. Composition.section:social_history_section.code
                                                                                                                      Definition

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

                                                                                                                      ShortSocial history
                                                                                                                      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.

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

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

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

                                                                                                                      Identifies who is responsible for the content.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      858. Composition.section:social_history_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()))
                                                                                                                      860. Composition.section:social_history_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
                                                                                                                      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()))
                                                                                                                      862. Composition.section:social_history_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()))
                                                                                                                      864. Composition.section:social_history_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()))
                                                                                                                      866. Composition.section:social_history_section.entry
                                                                                                                      Definition

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

                                                                                                                      Shortentry
                                                                                                                      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()))
                                                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • profile @ resolve()
                                                                                                                      • 868. Composition.section:social_history_section.entry:sliceEntry
                                                                                                                        Slice NamesliceEntry
                                                                                                                        Definition

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

                                                                                                                        ShortSmoking status
                                                                                                                        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(US Core Smoking Status Observation Profile)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        870. Composition.section:social_history_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()))
                                                                                                                        872. Composition.section:social_history_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()))
                                                                                                                        874. Composition.section:vital_signs_section
                                                                                                                        Slice Namevital_signs_section
                                                                                                                        Definition

                                                                                                                        The root of the sections that make up the composition.

                                                                                                                        ShortVital Signs Section
                                                                                                                        Comments

                                                                                                                        Vital Signs Section

                                                                                                                        Control0..1
                                                                                                                        TypeBackboneElement
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        LabelVital Signs Section
                                                                                                                        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()))
                                                                                                                        876. Composition.section:vital_signs_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
                                                                                                                        878. Composition.section:vital_signs_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())
                                                                                                                        880. Composition.section:vital_signs_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())
                                                                                                                        882. Composition.section:vital_signs_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.

                                                                                                                        Shorttitle
                                                                                                                        Comments

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

                                                                                                                        Control1..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        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()))
                                                                                                                        884. Composition.section:vital_signs_section.code
                                                                                                                        Definition

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

                                                                                                                        ShortVital signs
                                                                                                                        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.

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

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

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

                                                                                                                        Identifies who is responsible for the content.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        888. Composition.section:vital_signs_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()))
                                                                                                                        890. Composition.section:vital_signs_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
                                                                                                                        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()))
                                                                                                                        892. Composition.section:vital_signs_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()))
                                                                                                                        894. Composition.section:vital_signs_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()))
                                                                                                                        896. Composition.section:vital_signs_section.entry
                                                                                                                        Definition

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

                                                                                                                        Shortentry
                                                                                                                        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()))
                                                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • profile @ resolve()
                                                                                                                        • 898. Composition.section:vital_signs_section.entry:sliceEntry
                                                                                                                          Slice NamesliceEntry
                                                                                                                          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(Vital Signs Profile)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          900. Composition.section:vital_signs_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()))
                                                                                                                          902. Composition.section:vital_signs_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()))