Canonical Resource Management Infrastructure Implementation Guide
1.1.0-cibuild - cibuild International flag

Canonical Resource Management Infrastructure Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.1.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/crmi-ig/ and changes regularly. See the Directory of published versions

Resource Profile: CRMIPublishableValueSet - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the crmi-publishablevalueset resource profile.

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

0. ValueSet
Definition

A ValueSet resource instance specifies a set of codes drawn from one or more code systems, intended for use in a particular context. Value sets link between CodeSystem definitions and their use in coded elements.

ShortA set of codes drawn from one or more code systems
Control10..1*
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())
vsd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
vsd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
2. ValueSet.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. ValueSet.extension:copyrightLabel
Slice NamecopyrightLabel
Definition

A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').

ShortCopyright holder and year(s)
Comments

Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

Control0..1
TypeExtension(Artifact Copyright Label) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. ValueSet.extension:approvalDate
Slice NameapprovalDate
Definition

The date on which the artifact content was approved by the publisher. Approval happens once when the content is officially approved for usage.

ShortWhen the artifact was approved by publisher
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

Control0..1
TypeExtension(Artifact Approval Date) (Extension Type: date)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. ValueSet.extension:lastReviewDate
Slice NamelastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

ShortWhen the artifact was approved by publisher
Comments

If specified, this date follows the original approval date.

Control0..1
TypeExtension(Artifact Last Review Date) (Extension Type: date)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. ValueSet.extension:effectivePeriod
Slice NameeffectivePeriod
Definition

The period during which the artifact content was or is planned to be in active use.

ShortWhen the artifact is expected to be used
Comments

The effective period for an artifact determines when the content is applicable for usage and is independent of publication and review dates. For example, an artifact intended to be used for the year 2016 might be published in 2015.

Control0..1
TypeExtension(Artifact Effective Period) (Extension Type: Period)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. ValueSet.extension:topic
Slice Nametopic
Definition

Descriptive topics related to the content of the artifact. Topics provide a high-level categorization of the artifact that can be useful for filtering and searching.

ShortE.g. Education, Treatment, Assessment, etc.
Comments

This element provides a topical categorization of the artifact, as opposed to the more structured context-of-use information provided in the useContext element.

Control0..*
TypeExtension(Artifact Topic) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. ValueSet.extension:author
Slice Nameauthor
Definition

An individual or organization primarily involved in the creation and maintenance of the artifact.

ShortWho authored the artifact
Control0..*
TypeExtension(Artifact Author) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. ValueSet.extension:editor
Slice Nameeditor
Definition

An individual or organization primarily responsible for internal coherence of the artifact.

ShortWho edited the artifact
Control0..*
TypeExtension(Artifact Editor) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. ValueSet.extension:reviewer
Slice Namereviewer
Definition

An individual or organization primarily responsible for review of some aspect of the artifact.

ShortWho reviewed the artifact
Control0..*
TypeExtension(Artifact Reviewer) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. ValueSet.extension:endorser
Slice Nameendorser
Definition

An individual or organization responsible for officially endorsing the artifact for use in some setting.

ShortWho endorsed the artifact
Control0..*
TypeExtension(Artifact Endorser) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. ValueSet.extension:relatedArtifact
Slice NamerelatedArtifact
Definition

Related artifacts such as additional documentation, justification, dependencies, bibliographic references, and predecessor and successor artifacts.

ShortAdditional documentation, citations, etc.
Comments

Each related artifact is either an attachment, or a reference to another resource, but not both.

Control0..*
TypeExtension(Artifact related artifact) (Extension Type: RelatedArtifact)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. ValueSet.extension:trustedExpansion
Slice NametrustedExpansion
Definition

Indicates an authoritative source for performing value set expansions.

ShortReference to a trusted expansion
Comments

If the designated "authoritative source" (as specified in the valueset-authoritativeSource extension, if present) is unable to provide a valid expansion, this extension indicates an alternate authoritative source where the value set expansion may be performed. The alternate authoritative source url must reference a FHIR terminology server endpoint (the [base] url of the FHIR server).

Control0..1
TypeExtension(Valueset Trusted Expansion) (Extension Type: url)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. ValueSet.extension:otherTitle
Slice NameotherTitle
Definition

Human readable titles for the valueset.

ShortAlternative titles
Control0..*
TypeExtension(ValueSet Other Title) (Complex Extension)
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())
28. ValueSet.extension:sourceReference
Slice NamesourceReference
Definition

This text is intended to act as a citation to work done elsewhere that is not part of the current stewarding process where the referenced source is in some way a basis of the current value set definition.

ShortWhere did this content come from
Comments

This is not intended to be a direct link to another value set. It is only intended to support a link or textual description that indicates related material for the value set.

Control0..1
TypeExtension(ValueSet Source Reference) (Extension Type: uri)
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())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. ValueSet.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())
32. ValueSet.identifier
Definition

A formal identifier that is used to identify this value set when it is represented in other formats, or referenced in a specification, model, design or an instance.

ShortAdditional identifier for the value set (business identifier)
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this value set outside of FHIR, where it is not possible to use the logical URI.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

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

The status of this value set. Enables tracking the life-cycle of the content. The status of the value set applies to the value set definition (ValueSet.compose) and the associated ValueSet metadata. Expansions do not have a state.

Shortdraft | active | retired | unknown
Comments

Allows filtering of value sets that are appropriate for use versus not.See also the valueset-workflowStatus extension for additional status information related to the editorial process.

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

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
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()))
36. ValueSet.date
Definition

The date (and optionally time) when the value set was created or revised (e.g. the 'content logical definition').

ShortDate last changed
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the value set. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Control10..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesRevision Date
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ValueSet.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

ShortContact details for the publisher
Comments

May be a web site, an email address, a telephone number, etc.

Control0..*
TypeContactDetail
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ValueSet.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate value set instances.

ShortThe context that the content is intended to support
Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Control0..*
TypeUsageContext
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Assist in searching for appropriate content.

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

A legal or geographic region in which the value set is intended to be used.

ShortIntended jurisdiction for value set (if applicable)
Comments

It may be possible for the value set to be used in jurisdictions other than those for which it was originally designed or intended.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSethttp://hl7.org/fhir/ValueSet/jurisdiction
(extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

Countries and regions within which this artifact is targeted for use.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ValueSet.purpose
Definition

Explanation of why this value set is needed and why it has been designed as it has.

ShortWhy this value set is defined
Comments

This element does not describe the usage of the value set. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this value set.

Control0..1
Typemarkdown
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()))
46. ValueSet.copyright
Definition

A copyright statement relating to the value set and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the value set.

ShortUse and/or publishing restrictions
Comments

nullFrequently, the copyright differs between the value set and the codes that are included. The copyright statement should clearly differentiate between these when required.

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

Consumers must be able to determine any legal restrictions on the use of the value set and/or its content.

Alternate NamesLicense, Restrictions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. ValueSet.compose
Definition

A set of criteria that define the contents of the value set by including or excluding codes selected from the specified code system(s) that the value set draws from. This is also known as the Content Logical Definition (CLD).

ShortContent logical definition of the value set (CLD)
Control0..1
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Alternate NamesContent Logical Definition, CLD
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. ValueSet.compose.extension:composeCreatedBy
Slice NamecomposeCreatedBy
Definition

User who created the compose for the ValueSet.

ShortExtension
Control0..1
TypeExtension(ValueSet Compose CreatedBy) (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())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. ValueSet.compose.extension:composeCreationDate
Slice NamecomposeCreationDate
Definition

Date the compose was created.

ShortExtension
Control0..1
TypeExtension(ValueSet Compose Creation Date) (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())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
54. ValueSet.compose.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())
56. ValueSet.compose.include
Definition

Include one or more codes from a code system or other value set(s).

ShortInclude one or more codes from a code system or other value set(s)
Comments

All the conditions in an include must be true. If a system is listed, all the codes from the system are listed. If one or more filters are listed, all of the filters must apply. If one or more value sets are listed, the codes must be in all the value sets. E.g. each include is 'include all the codes that meet all these conditions'.

Control1..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
vsd-1: A value set include/exclude SHALL have a value set or a system (valueSet.exists() or system.exists())
vsd-2: A value set with concepts or filters SHALL include a system ((concept.exists() or filter.exists()) implies system.exists())
vsd-3: Cannot have both concept and filter (concept.empty() or filter.empty())
vsd-1: A value set include/exclude SHALL have a value set or a system (valueSet.exists() or system.exists())
vsd-2: A value set with concepts or filters SHALL include a system ((concept.exists() or filter.exists()) implies system.exists())
vsd-3: Cannot have both concept and filter (concept.empty() or filter.empty())
58. ValueSet.compose.include.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

An absolute URI which is the code system from which the selected codes come from.

ShortThe system the codes come from
Comments

If there are no codes or filters, the entire code system is included. Note that the set of codes that are included may contain abstract codes. See ''Coding.system'' for further documentation about the correct value for the system element.

Control0..1
This element is affected by the following invariants: vsd-1, vsd-2
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))