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: ProgressNote - Detailed Descriptions

Active as of 2025-02-12

Definitions for the Progress-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.

ShorttypeKind 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 ProgressNoteDocumentTypeCodehttp://hl7.org/fhir/ValueSet/doc-typecodes
(required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.8.1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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

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

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

Provides context for the composition and supports searching.

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

      The root of the sections that make up the composition.

      ShortAssessment SectionComposition is broken into sections
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      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())
      82. 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())
      84. 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
      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:assessment_section.code
      Definition

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

      ShortAssessmentsClassification 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.

      LabelAssessments
      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()))
      88. 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
      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
      Slice Nameallergies_and_intolerances_section
      Definition

      The root of the sections that make up the composition.

      ShortAllergies and Intolerances SectionComposition is broken into sections
      Control0..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())
      92. 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())
      94. 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()))
      96. 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, adverse reactions, alertsClassification 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, adverse reactions, alerts
      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()))
      98. 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
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      100. 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()
      • 102. Composition.section:allergies_and_intolerances_section.entry:allergies_and_intolerances_entry
        Slice Nameallergies_and_intolerances_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()))
        104. 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
        Control0..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        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())
        106. 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())
        108. 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
        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: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 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
        Must Supporttrue
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        LabelAssessment 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()))
        112. 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
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        114. 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()
        • 116. Composition.section:assessment_and_plan_section.entry:assessment_and_plan_entry
          Slice Nameassessment_and_plan_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(US Core Condition Profile, Observation, Communication, 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()))
          118. 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
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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())
          120. 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())
          122. 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
          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()))
          124. 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
          Must Supporttrue
          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()))
          126. 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
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. Composition.section:instructions_section
          Slice Nameinstructions_section
          Definition

          The root of the sections that make up the composition.

          ShortInstructions SectionComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          LabelInstructions 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())
          130. Composition.section:instructions_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())
          132. Composition.section:instructions_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()))
          134. Composition.section:instructions_section.code
          Definition

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

          ShortInstructionsClassification 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.

          LabelInstructions
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "69730-0"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          136. Composition.section:instructions_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()))
          138. Composition.section:interventions_section
          Slice Nameinterventions_section
          Definition

          The root of the sections that make up the composition.

          ShortInterventions SectionComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          LabelInterventions 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())
          140. Composition.section:interventions_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())
          142. Composition.section:interventions_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()))
          144. Composition.section:interventions_section.code
          Definition

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

          ShortInterventions providedClassification 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.

          LabelInterventions provided
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "62387-6"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          146. Composition.section:interventions_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()))
          148. Composition.section:interventions_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()
          • 150. Composition.section:interventions_section.entry:interventions_section
            Slice Nameinterventions_section
            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(List, RequestGroup, 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()))
            152. Composition.section:medications_section
            Slice Namemedications_section
            Definition

            The root of the sections that make up the composition.

            ShortMedications SectionComposition is broken into sections
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            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())
            154. 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())
            156. 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
            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()))
            158. 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
            Must Supporttrue
            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()))
            160. 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
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            162. 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()
            • 164. Composition.section:medications_section.entry:medications_entry
              Slice Namemedications_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(MedicationStatement, US Core Medication Profile, US Core MedicationRequest 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()))
              166. Composition.section:nutrition_section
              Slice Namenutrition_section
              Definition

              The root of the sections that make up the composition.

              ShortNutrition SectionComposition is broken into sections
              Control0..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              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())
              168. 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())
              170. 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
              Must Supporttrue
              Summaryfalse
              Requirements

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

              Alternate Namesheader, label, caption
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              172. Composition.section: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
              Must Supporttrue
              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()))
              174. 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
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              176. 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
              Must Supporttrue
              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()
              • 178. Composition.section:nutrition_section.entry:nutrition_entry
                Slice Namenutrition_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(Observation, Resource)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                180. Composition.section:objective_section
                Slice Nameobjective_section
                Definition

                The root of the sections that make up the composition.

                ShortObjective SectionComposition is broken into sections
                Control0..1*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                LabelObjective 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())
                182. Composition.section:objective_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())
                184. Composition.section:objective_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()))
                186. Composition.section:objective_section.code
                Definition

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

                ShortObjectiveClassification 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.

                LabelObjective
                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "61149-1"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                188. Composition.section:objective_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()))
                190. 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
                Must Supporttrue
                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())
                192. 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())
                194. 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
                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()))
                196. 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
                Must Supporttrue
                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()))
                198. 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
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                200. 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()
                • 202. Composition.section:physical_exam_section.entry:physical_exam_entry
                  Slice Namephysical_exam_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(Observation, Resource)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  204. 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
                  Control0..1*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  206. 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())
                  208. 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
                  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()))
                  210. 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
                  Must Supporttrue
                  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()))
                  212. 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
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  214. 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()
                  • 216. 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()))
                    218. Composition.section:problems_section
                    Slice Nameproblems_section
                    Definition

                    The root of the sections that make up the composition.

                    ShortProblems SectionComposition is broken into sections
                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    LabelProblems 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:problems_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:problems_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()))
                    224. Composition.section:problems_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()))
                    226. Composition.section:problems_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()))
                    228. Composition.section:problems_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:problems_section.entry:problem_entry
                      Slice Nameproblem_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()))
                      232. Composition.section:results_section
                      Slice Nameresults_section
                      Definition

                      The root of the sections that make up the composition.

                      ShortResults SectionComposition is broken into sections
                      Control0..1*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      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())
                      234. 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())
                      236. 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
                      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()))
                      238. 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 and/or 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
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Provides computable standardized labels to topics within the document.

                      LabelRelevant diagnostic tests and/or 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()))
                      240. 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
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      242. 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
                      Must Supporttrue
                      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:results_section.entry:results_entry
                        Slice Nameresults_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 Laboratory Result Observation Profile, Resource)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        246. 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
                        Control0..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        248. 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())
                        250. 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
                        Must Supporttrue
                        Summaryfalse
                        Requirements

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

                        Alternate Namesheader, label, caption
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        252. Composition.section: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
                        Must Supporttrue
                        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()))
                        254. 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
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        256. Composition.section:subjective_section
                        Slice Namesubjective_section
                        Definition

                        The root of the sections that make up the composition.

                        ShortSubjective SectionComposition is broken into sections
                        Control0..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        LabelSubjective 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:subjective_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:subjective_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()))
                        262. Composition.section:subjective_section.code
                        Definition

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

                        ShortSubjectiveClassification 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.

                        LabelSubjective
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "61150-9"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        264. Composition.section:subjective_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()))
                        266. 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
                        Control0..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        268. 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())
                        270. 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
                        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()))
                        272. 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
                        Must Supporttrue
                        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()))
                        274. 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
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        276. 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()
                        • 278. Composition.section:vital_signs_section.entry:vital_signs_entry
                          Slice Namevital_signs_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(Vital Signs Profile, Resource)
                          Is Modifierfalse
                          Must Supporttrue
                          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
                          Shorttype
                          BindingThe codes SHALL be taken from ProgressNoteDocumentTypeCode
                          (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.8.1)
                          Must Supporttrue
                          4. 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
                          • 6. Composition.section:assessment_section
                            Slice Nameassessment_section
                            ShortAssessment Section
                            Control0..1
                            Must Supporttrue
                            LabelAssessment Section
                            8. Composition.section:assessment_section.title
                            Shorttitle
                            Control1..?
                            Must Supporttrue
                            10. Composition.section:assessment_section.code
                            ShortAssessments
                            Control1..?
                            Must Supporttrue
                            LabelAssessments
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "51848-0"
                              }]
                            }
                            12. Composition.section:assessment_section.text
                            ShortThis section contains only human readable content
                            Control1..?
                            Must Supporttrue
                            14. Composition.section:allergies_and_intolerances_section
                            Slice Nameallergies_and_intolerances_section
                            ShortAllergies and Intolerances Section
                            Control0..1
                            Must Supporttrue
                            LabelAllergies and Intolerances Section
                            16. Composition.section:allergies_and_intolerances_section.title
                            Shorttitle
                            Control1..?
                            Must Supporttrue
                            18. Composition.section:allergies_and_intolerances_section.code
                            ShortAllergies, adverse reactions, alerts
                            Control1..?
                            Must Supporttrue
                            LabelAllergies, adverse reactions, alerts
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "48765-2"
                              }]
                            }
                            20. Composition.section:allergies_and_intolerances_section.text
                            Shorttext
                            Control1..?
                            22. 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()
                            • 24. Composition.section:allergies_and_intolerances_section.entry:allergies_and_intolerances_entry
                              Slice Nameallergies_and_intolerances_entry
                              TypeReference(US Core AllergyIntolerance Profile)
                              Must Supporttrue
                              26. 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.
                              Control0..1
                              Must Supporttrue
                              LabelAssessment and Plan Section
                              28. Composition.section:assessment_and_plan_section.title
                              Shorttitle
                              Control1..?
                              Must Supporttrue
                              30. Composition.section:assessment_and_plan_section.code
                              ShortAssessment and plan
                              Control1..?
                              Must Supporttrue
                              LabelAssessment and plan
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "51847-2"
                                }]
                              }
                              32. Composition.section:assessment_and_plan_section.text
                              Shorttext
                              Control1..?
                              Must Supporttrue
                              34. 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()
                              • 36. Composition.section:assessment_and_plan_section.entry:assessment_and_plan_entry
                                Slice Nameassessment_and_plan_entry
                                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)
                                Must Supporttrue
                                Must Support TypesNo must-support rules about the choice of types/profiles
                                38. Composition.section:chief_complaint_section
                                Slice Namechief_complaint_section
                                ShortChief Complaint Section
                                Control0..1
                                Must Supporttrue
                                LabelChief Complaint Section
                                40. Composition.section:chief_complaint_section.title
                                Shorttitle
                                Control1..?
                                Must Supporttrue
                                42. Composition.section:chief_complaint_section.code
                                ShortChief complaint
                                Control1..?
                                Must Supporttrue
                                LabelChief complaint
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "10154-3"
                                  }]
                                }
                                44. Composition.section:chief_complaint_section.text
                                ShortThis section contains only human readable content
                                Control1..?
                                Must Supporttrue
                                46. Composition.section:instructions_section
                                Slice Nameinstructions_section
                                ShortInstructions Section
                                Control0..1
                                Must Supporttrue
                                LabelInstructions Section
                                48. Composition.section:instructions_section.title
                                Shorttitle
                                Control1..?
                                Must Supporttrue
                                50. Composition.section:instructions_section.code
                                ShortInstructions
                                Control1..?
                                Must Supporttrue
                                LabelInstructions
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "69730-0"
                                  }]
                                }
                                52. Composition.section:instructions_section.text
                                ShortThis section contains only human readable content
                                Control1..?
                                Must Supporttrue
                                54. Composition.section:interventions_section
                                Slice Nameinterventions_section
                                ShortInterventions Section
                                Control0..1
                                Must Supporttrue
                                LabelInterventions Section
                                56. Composition.section:interventions_section.title
                                Shorttitle
                                Control1..?
                                Must Supporttrue
                                58. Composition.section:interventions_section.code
                                ShortInterventions provided
                                Control1..?
                                Must Supporttrue
                                LabelInterventions provided
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "62387-6"
                                  }]
                                }
                                60. Composition.section:interventions_section.text
                                Shorttext
                                Control1..?
                                Must Supporttrue
                                62. Composition.section:interventions_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()
                                • 64. Composition.section:interventions_section.entry:interventions_section
                                  Slice Nameinterventions_section
                                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                  TypeReference(List, RequestGroup)
                                  Must Supporttrue
                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                  66. Composition.section:medications_section
                                  Slice Namemedications_section
                                  ShortMedications Section
                                  Control0..1
                                  Must Supporttrue
                                  LabelMedications Section
                                  68. Composition.section:medications_section.title
                                  Shorttitle
                                  Control1..?
                                  Must Supporttrue
                                  70. Composition.section:medications_section.code
                                  ShortHistory of medication use
                                  Control1..?
                                  Must Supporttrue
                                  LabelHistory of medication use
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "10160-0"
                                    }]
                                  }
                                  72. Composition.section:medications_section.text
                                  Shorttext
                                  Control1..?
                                  Must Supporttrue
                                  74. 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()
                                  • 76. Composition.section:medications_section.entry:medications_entry
                                    Slice Namemedications_entry
                                    TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile)
                                    Must Supporttrue
                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                    78. Composition.section:nutrition_section
                                    Slice Namenutrition_section
                                    ShortNutrition Section
                                    Control0..1
                                    Must Supporttrue
                                    LabelNutrition Section
                                    80. Composition.section:nutrition_section.title
                                    Shorttitle
                                    Control1..?
                                    Must Supporttrue
                                    82. Composition.section:nutrition_section.code
                                    ShortDiet and nutrition
                                    Control1..?
                                    Must Supporttrue
                                    LabelDiet and nutrition
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "61144-2"
                                      }]
                                    }
                                    84. Composition.section:nutrition_section.text
                                    Shorttext
                                    Control1..?
                                    Must Supporttrue
                                    86. Composition.section:nutrition_section.entry
                                    Shortentry
                                    Must Supporttrue
                                    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()
                                    • 88. Composition.section:nutrition_section.entry:nutrition_entry
                                      Slice Namenutrition_entry
                                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                      TypeReference(Observation)
                                      Must Supporttrue
                                      90. Composition.section:objective_section
                                      Slice Nameobjective_section
                                      ShortObjective Section
                                      Control0..1
                                      Must Supporttrue
                                      LabelObjective Section
                                      92. Composition.section:objective_section.title
                                      Shorttitle
                                      Control1..?
                                      Must Supporttrue
                                      94. Composition.section:objective_section.code
                                      ShortObjective
                                      Control1..?
                                      Must Supporttrue
                                      LabelObjective
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "61149-1"
                                        }]
                                      }
                                      96. Composition.section:objective_section.text
                                      ShortThis section contains only human readable content
                                      Control1..?
                                      Must Supporttrue
                                      98. Composition.section:physical_exam_section
                                      Slice Namephysical_exam_section
                                      ShortPhysical Exam Section
                                      Comments

                                      Physical Exam Section

                                      Control0..1
                                      Must Supporttrue
                                      LabelPhysical Exam Section
                                      100. Composition.section:physical_exam_section.title
                                      Shorttitle
                                      Control1..?
                                      Must Supporttrue
                                      102. Composition.section:physical_exam_section.code
                                      ShortPhysical findings
                                      Control1..?
                                      Must Supporttrue
                                      LabelPhysical findings
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "29545-1"
                                        }]
                                      }
                                      104. Composition.section:physical_exam_section.text
                                      Shorttext
                                      Control1..?
                                      Must Supporttrue
                                      106. 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()
                                      • 108. Composition.section:physical_exam_section.entry:physical_exam_entry
                                        Slice Namephysical_exam_entry
                                        ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                        TypeReference(Observation)
                                        Must Supporttrue
                                        110. Composition.section:plan_of_treatment_section
                                        Slice Nameplan_of_treatment_section
                                        ShortPlan of Treatment Section
                                        Control0..1
                                        Must Supporttrue
                                        LabelPlan of Treatment Section
                                        112. Composition.section:plan_of_treatment_section.title
                                        Shorttitle
                                        Control1..?
                                        Must Supporttrue
                                        114. Composition.section:plan_of_treatment_section.code
                                        ShortPlan of Treatment
                                        Control1..?
                                        Must Supporttrue
                                        LabelPlan of Treatment
                                        Pattern Value{
                                          "coding" : [{
                                            "system" : "http://loinc.org",
                                            "code" : "18776-5"
                                          }]
                                        }
                                        116. Composition.section:plan_of_treatment_section.text
                                        Shorttext
                                        Control1..?
                                        Must Supporttrue
                                        118. 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()
                                        • 120. 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)
                                          122. Composition.section:problems_section
                                          Slice Nameproblems_section
                                          ShortProblems Section
                                          Control0..1
                                          Must Supporttrue
                                          LabelProblems Section
                                          124. Composition.section:problems_section.title
                                          Shorttitle
                                          Control1..?
                                          Must Supporttrue
                                          126. Composition.section:problems_section.code
                                          ShortProblem list
                                          Control1..?
                                          Must Supporttrue
                                          LabelProblem list
                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "http://loinc.org",
                                              "code" : "11450-4"
                                            }]
                                          }
                                          128. Composition.section:problems_section.text
                                          Shorttext
                                          Control1..?
                                          Must Supporttrue
                                          130. Composition.section:problems_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()
                                          • 132. Composition.section:problems_section.entry:problem_entry
                                            Slice Nameproblem_entry
                                            TypeReference(US Core Condition Profile)
                                            Must Supporttrue
                                            134. Composition.section:results_section
                                            Slice Nameresults_section
                                            ShortResults Section
                                            Control0..1
                                            Must Supporttrue
                                            LabelResults Section
                                            136. Composition.section:results_section.title
                                            Shorttitle
                                            Control1..?
                                            Must Supporttrue
                                            138. Composition.section:results_section.code
                                            ShortRelevant diagnostic tests and/or laboratory data
                                            Control1..?
                                            Must Supporttrue
                                            LabelRelevant diagnostic tests and/or laboratory data
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "30954-2"
                                              }]
                                            }
                                            140. Composition.section:results_section.text
                                            Shorttext
                                            Control1..?
                                            Must Supporttrue
                                            142. Composition.section:results_section.entry
                                            Shortentry
                                            Must Supporttrue
                                            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:results_section.entry:results_entry
                                              Slice Nameresults_entry
                                              TypeReference(US Core Laboratory Result Observation Profile)
                                              Must Supporttrue
                                              146. Composition.section:review_of_systems_section
                                              Slice Namereview_of_systems_section
                                              ShortReview of Systems Section
                                              Control0..1
                                              Must Supporttrue
                                              LabelReview of Systems Section
                                              148. Composition.section:review_of_systems_section.title
                                              Shorttitle
                                              Control1..?
                                              Must Supporttrue
                                              150. Composition.section:review_of_systems_section.code
                                              ShortReview of systems
                                              Control1..?
                                              Must Supporttrue
                                              LabelReview of systems
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "10187-3"
                                                }]
                                              }
                                              152. Composition.section:review_of_systems_section.text
                                              ShortThis section contains only human readable content
                                              Control1..?
                                              Must Supporttrue
                                              154. Composition.section:subjective_section
                                              Slice Namesubjective_section
                                              ShortSubjective Section
                                              Control0..1
                                              Must Supporttrue
                                              LabelSubjective Section
                                              156. Composition.section:subjective_section.title
                                              Shorttitle
                                              Control1..?
                                              Must Supporttrue
                                              158. Composition.section:subjective_section.code
                                              ShortSubjective
                                              Control1..?
                                              Must Supporttrue
                                              LabelSubjective
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "61150-9"
                                                }]
                                              }
                                              160. Composition.section:subjective_section.text
                                              ShortThis section contains only human readable content
                                              Control1..?
                                              Must Supporttrue
                                              162. Composition.section:vital_signs_section
                                              Slice Namevital_signs_section
                                              ShortVital Signs Section
                                              Control0..1
                                              Must Supporttrue
                                              LabelVital Signs Section
                                              164. Composition.section:vital_signs_section.title
                                              Shorttitle
                                              Control1..?
                                              Must Supporttrue
                                              166. Composition.section:vital_signs_section.code
                                              ShortVital signs
                                              Control1..?
                                              Must Supporttrue
                                              LabelVital signs
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "8716-3"
                                                }]
                                              }
                                              168. Composition.section:vital_signs_section.text
                                              Shorttext
                                              Control1..?
                                              Must Supporttrue
                                              170. 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()
                                              • 172. Composition.section:vital_signs_section.entry:vital_signs_entry
                                                Slice Namevital_signs_entry
                                                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                TypeReference(Vital Signs Profile)
                                                Must Supporttrue

                                                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.

                                                  Shorttype
                                                  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 ProgressNoteDocumentTypeCode
                                                  (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.8.1)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

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

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

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

                                                  Provides context for the composition and supports searching.

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

                                                      The root of the sections that make up the composition.

                                                      ShortAssessment Section
                                                      Control0..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      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()))
                                                      170. 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
                                                      172. 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())
                                                      174. 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())
                                                      176. 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
                                                      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:assessment_section.code
                                                      Definition

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

                                                      ShortAssessments
                                                      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.

                                                      LabelAssessments
                                                      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()))
                                                      180. 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()))
                                                      182. 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()))
                                                      184. 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
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      186. 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()))
                                                      188. 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()))
                                                      190. 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()))
                                                      192. 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()))
                                                      194. 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()))
                                                      196. 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
                                                      Control0..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()))
                                                      198. 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
                                                      200. 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())
                                                      202. 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())
                                                      204. 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()))
                                                      206. 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, adverse reactions, alerts
                                                      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, adverse reactions, alerts
                                                      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()))
                                                      208. 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()))
                                                      210. 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()))
                                                      212. 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
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      214. 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()))
                                                      216. 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()))
                                                      218. 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()
                                                      • 220. Composition.section:allergies_and_intolerances_section.entry:allergies_and_intolerances_entry
                                                        Slice Nameallergies_and_intolerances_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()))
                                                        222. 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()))
                                                        224. 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()))
                                                        226. 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.
                                                        Control0..1
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        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()))
                                                        228. 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
                                                        230. 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())
                                                        232. 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())
                                                        234. 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
                                                        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: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 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
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Provides computable standardized labels to topics within the document.

                                                        LabelAssessment 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()))
                                                        238. 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()))
                                                        240. 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()))
                                                        242. 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
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        244. 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()))
                                                        246. 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()))
                                                        248. 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()
                                                        • 250. Composition.section:assessment_and_plan_section.entry:assessment_and_plan_entry
                                                          Slice Nameassessment_and_plan_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(US Core Condition Profile, Observation, Communication)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          252. Composition.section: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()))
                                                          254. 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()))
                                                          256. Composition.section:chief_complaint_section
                                                          Slice Namechief_complaint_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortChief Complaint Section
                                                          Control0..1
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          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()))
                                                          258. 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
                                                          260. 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())
                                                          262. 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())
                                                          264. 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
                                                          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()))
                                                          266. 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
                                                          Must Supporttrue
                                                          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()))
                                                          268. 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()))
                                                          270. 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()))
                                                          272. 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
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          274. 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()))
                                                          276. 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()))
                                                          278. 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()))
                                                          280. 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()))
                                                          282. 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()))
                                                          284. Composition.section:instructions_section
                                                          Slice Nameinstructions_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortInstructions Section
                                                          Control0..1
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          LabelInstructions 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()))
                                                          286. Composition.section:instructions_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
                                                          288. Composition.section:instructions_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())
                                                          290. Composition.section:instructions_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())
                                                          292. Composition.section:instructions_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()))
                                                          294. Composition.section:instructions_section.code
                                                          Definition

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

                                                          ShortInstructions
                                                          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.

                                                          LabelInstructions
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "69730-0"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          296. Composition.section:instructions_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()))
                                                          298. Composition.section:instructions_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()))
                                                          300. Composition.section:instructions_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()))
                                                          302. Composition.section:instructions_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()))
                                                          304. Composition.section:instructions_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()))
                                                          306. Composition.section:instructions_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()))
                                                          308. Composition.section:instructions_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()))
                                                          310. Composition.section:instructions_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()))
                                                          312. Composition.section:interventions_section
                                                          Slice Nameinterventions_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortInterventions Section
                                                          Control0..1
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          LabelInterventions 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()))
                                                          314. Composition.section:interventions_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
                                                          316. Composition.section:interventions_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())
                                                          318. Composition.section:interventions_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())
                                                          320. Composition.section:interventions_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()))
                                                          322. Composition.section:interventions_section.code
                                                          Definition

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

                                                          ShortInterventions provided
                                                          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.

                                                          LabelInterventions provided
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "62387-6"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          324. Composition.section:interventions_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()))
                                                          326. Composition.section:interventions_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()))
                                                          328. Composition.section:interventions_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()))
                                                          330. Composition.section:interventions_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()))
                                                          332. Composition.section:interventions_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()))
                                                          334. Composition.section:interventions_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()
                                                          • 336. Composition.section:interventions_section.entry:interventions_section
                                                            Slice Nameinterventions_section
                                                            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(List, RequestGroup)
                                                            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()))
                                                            338. Composition.section:interventions_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()))
                                                            340. Composition.section:interventions_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()))
                                                            342. Composition.section:medications_section
                                                            Slice Namemedications_section
                                                            Definition

                                                            The root of the sections that make up the composition.

                                                            ShortMedications Section
                                                            Control0..1
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            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()))
                                                            344. 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
                                                            346. 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())
                                                            348. 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())
                                                            350. 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
                                                            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()))
                                                            352. 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
                                                            Must Supporttrue
                                                            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()))
                                                            354. 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()))
                                                            356. 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()))
                                                            358. 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
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            360. 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()))
                                                            362. 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()))
                                                            364. 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()
                                                            • 366. Composition.section:medications_section.entry:medications_entry
                                                              Slice Namemedications_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(MedicationStatement, US Core Medication Profile, US Core MedicationRequest 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()))
                                                              368. 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()))
                                                              370. 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()))
                                                              372. Composition.section:nutrition_section
                                                              Slice Namenutrition_section
                                                              Definition

                                                              The root of the sections that make up the composition.

                                                              ShortNutrition Section
                                                              Control0..1
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              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()))
                                                              374. 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
                                                              376. 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())
                                                              378. 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())
                                                              380. 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
                                                              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()))
                                                              382. 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
                                                              Must Supporttrue
                                                              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()))
                                                              384. 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()))
                                                              386. 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()))
                                                              388. 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
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              390. 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()))
                                                              392. 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()))
                                                              394. 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
                                                              Must Supporttrue
                                                              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()
                                                              • 396. Composition.section:nutrition_section.entry:nutrition_entry
                                                                Slice Namenutrition_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(Observation)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                398. 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()))
                                                                400. 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()))
                                                                402. Composition.section:objective_section
                                                                Slice Nameobjective_section
                                                                Definition

                                                                The root of the sections that make up the composition.

                                                                ShortObjective Section
                                                                Control0..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                LabelObjective 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()))
                                                                404. Composition.section:objective_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
                                                                406. Composition.section:objective_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())
                                                                408. Composition.section:objective_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())
                                                                410. Composition.section:objective_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()))
                                                                412. Composition.section:objective_section.code
                                                                Definition

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

                                                                ShortObjective
                                                                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.

                                                                LabelObjective
                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://loinc.org",
                                                                    "code" : "61149-1"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                414. Composition.section:objective_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()))
                                                                416. Composition.section:objective_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()))
                                                                418. Composition.section:objective_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()))
                                                                420. Composition.section:objective_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()))
                                                                422. Composition.section:objective_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()))
                                                                424. Composition.section:objective_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()))
                                                                426. Composition.section:objective_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()))
                                                                428. Composition.section:objective_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()))
                                                                430. 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
                                                                Must Supporttrue
                                                                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()))
                                                                432. 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
                                                                434. 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())
                                                                436. 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())
                                                                438. 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
                                                                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()))
                                                                440. 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
                                                                Must Supporttrue
                                                                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()))
                                                                442. 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()))
                                                                444. 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()))
                                                                446. 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
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                448. 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()))
                                                                450. 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()))
                                                                452. 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()
                                                                • 454. Composition.section:physical_exam_section.entry:physical_exam_entry
                                                                  Slice Namephysical_exam_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(Observation)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  456. 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()))
                                                                  458. 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()))
                                                                  460. 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
                                                                  Control0..1
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  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()))
                                                                  462. 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
                                                                  464. 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())
                                                                  466. 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())
                                                                  468. 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
                                                                  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()))
                                                                  470. 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
                                                                  Must Supporttrue
                                                                  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()))
                                                                  472. 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()))
                                                                  474. 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()))
                                                                  476. 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
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  478. 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()))
                                                                  480. 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()))
                                                                  482. 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()
                                                                  • 484. 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()))
                                                                    486. 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()))
                                                                    488. 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()))
                                                                    490. Composition.section:problems_section
                                                                    Slice Nameproblems_section
                                                                    Definition

                                                                    The root of the sections that make up the composition.

                                                                    ShortProblems Section
                                                                    Control0..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    LabelProblems 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:problems_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:problems_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:problems_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:problems_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()))
                                                                    500. Composition.section:problems_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()))
                                                                    502. Composition.section:problems_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:problems_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:problems_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()))
                                                                    508. Composition.section:problems_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:problems_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:problems_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:problems_section.entry:problem_entry
                                                                      Slice Nameproblem_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()))
                                                                      516. Composition.section:problems_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:problems_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:results_section
                                                                      Slice Nameresults_section
                                                                      Definition

                                                                      The root of the sections that make up the composition.

                                                                      ShortResults Section
                                                                      Control0..1
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      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()))
                                                                      522. 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
                                                                      524. 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())
                                                                      526. 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())
                                                                      528. 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
                                                                      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()))
                                                                      530. 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 and/or 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
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Provides computable standardized labels to topics within the document.

                                                                      LabelRelevant diagnostic tests and/or 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()))
                                                                      532. 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()))
                                                                      534. 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()))
                                                                      536. 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
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      538. 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()))
                                                                      540. 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()))
                                                                      542. 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
                                                                      Must Supporttrue
                                                                      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:results_section.entry:results_entry
                                                                        Slice Nameresults_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 Laboratory Result Observation Profile)
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        546. Composition.section: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()))
                                                                        548. 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()))
                                                                        550. 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
                                                                        Control0..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        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()))
                                                                        552. 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
                                                                        554. 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())
                                                                        556. 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())
                                                                        558. 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
                                                                        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()))
                                                                        560. 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
                                                                        Must Supporttrue
                                                                        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()))
                                                                        562. 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()))
                                                                        564. 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()))
                                                                        566. 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
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        568. 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()))
                                                                        570. 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()))
                                                                        572. 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()))
                                                                        574. 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()))
                                                                        576. 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()))
                                                                        578. Composition.section:subjective_section
                                                                        Slice Namesubjective_section
                                                                        Definition

                                                                        The root of the sections that make up the composition.

                                                                        ShortSubjective Section
                                                                        Control0..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        LabelSubjective 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:subjective_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:subjective_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:subjective_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:subjective_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()))
                                                                        588. Composition.section:subjective_section.code
                                                                        Definition

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

                                                                        ShortSubjective
                                                                        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.

                                                                        LabelSubjective
                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://loinc.org",
                                                                            "code" : "61150-9"
                                                                          }]
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        590. Composition.section:subjective_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:subjective_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:subjective_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()))
                                                                        596. Composition.section:subjective_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:subjective_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:subjective_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()))
                                                                        602. Composition.section:subjective_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()))
                                                                        604. Composition.section:subjective_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()))
                                                                        606. Composition.section:vital_signs_section
                                                                        Slice Namevital_signs_section
                                                                        Definition

                                                                        The root of the sections that make up the composition.

                                                                        ShortVital Signs Section
                                                                        Control0..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        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()))
                                                                        608. 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
                                                                        610. 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())
                                                                        612. 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())
                                                                        614. 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
                                                                        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()))
                                                                        616. 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
                                                                        Must Supporttrue
                                                                        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()))
                                                                        618. 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()))
                                                                        620. 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()))
                                                                        622. 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
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        624. 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()))
                                                                        626. 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()))
                                                                        628. 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()
                                                                        • 630. Composition.section:vital_signs_section.entry:vital_signs_entry
                                                                          Slice Namevital_signs_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(Vital Signs Profile)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          632. 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()))
                                                                          634. 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()))