Evidence Based Medicine on FHIR Implementation Guide
2.0.0-ballot - ballot International flag

Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. 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/ebm/ and changes regularly. See the Directory of published versions

Resource Profile: SummaryOfNetEffect - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the summary-of-net-effect resource profile.

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

0. Composition
2. Composition.type
4. Composition.type.coding
Control1..1
Pattern Value{
  "system" : "https://fevir.net/resources/CodeSystem/179423",
  "code" : "SummaryOfNetEffect",
  "display" : "SummaryOfNetEffect"
}
6. Composition.type.text
Pattern ValueSummary of Net Effect Contributions
8. Composition.section
Control2..?
10. Composition.section:columnHeaders
Slice NamecolumnHeaders
Control1..1
Must Supporttrue
12. Composition.section:columnHeaders.code
14. Composition.section:columnHeaders.code.coding
Control1..1
Pattern Value{
  "system" : "https://fevir.net/resources/CodeSystem/179423",
  "code" : "column-headers",
  "display" : "Column Headers"
}
16. Composition.section:columnHeaders.section
Control2..?
SlicingThis element introduces a set of slices on Composition.section.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ code.coding
  • 18. Composition.section:columnHeaders.section:outcomeDefinition
    Slice NameoutcomeDefinition
    Control1..1
    TypeBackboneElement
    Must Supporttrue
    20. Composition.section:columnHeaders.section:outcomeDefinition.code
    22. Composition.section:columnHeaders.section:outcomeDefinition.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "outcome-measure",
      "display" : "Outcome Measure"
    }
    24. Composition.section:columnHeaders.section:outcomeDesirability
    Slice NameoutcomeDesirability
    Control0..1
    TypeBackboneElement
    26. Composition.section:columnHeaders.section:outcomeDesirability.code
    28. Composition.section:columnHeaders.section:outcomeDesirability.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "outcome-desirability",
      "display" : "Outcome Desirability"
    }
    30. Composition.section:columnHeaders.section:relativeImportance
    Slice NamerelativeImportance
    Control0..1
    TypeBackboneElement
    32. Composition.section:columnHeaders.section:relativeImportance.code
    34. Composition.section:columnHeaders.section:relativeImportance.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "relative-importance",
      "display" : "Relative Importance"
    }
    36. Composition.section:columnHeaders.section:resultWithoutTreatment
    Slice NameresultWithoutTreatment
    Control0..1
    TypeBackboneElement
    38. Composition.section:columnHeaders.section:resultWithoutTreatment.code
    40. Composition.section:columnHeaders.section:resultWithoutTreatment.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "result-with-comparator-alone",
      "display" : "Result with comparator alone"
    }
    42. Composition.section:columnHeaders.section:resultWithTreatmentObserved
    Slice NameresultWithTreatmentObserved
    Control0..1
    TypeBackboneElement
    44. Composition.section:columnHeaders.section:resultWithTreatmentObserved.code
    46. Composition.section:columnHeaders.section:resultWithTreatmentObserved.code.coding
    Control1..1
    Pattern Value{
      "system" : "http://hl7.org/fhir/evidence-report-section",
      "code" : "Intervention-group-alone-Evidence",
      "display" : "Evidence Results for the intervention exposure only"
    }
    48. Composition.section:columnHeaders.section:resultWithTreatmentDerived
    Slice NameresultWithTreatmentDerived
    Control0..1
    TypeBackboneElement
    50. Composition.section:columnHeaders.section:resultWithTreatmentDerived.code
    52. Composition.section:columnHeaders.section:resultWithTreatmentDerived.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "result-with-intervention-alone-calculated",
      "display" : "Result with intervention alone (calculated)"
    }
    54. Composition.section:columnHeaders.section:effectEstimate
    Slice NameeffectEstimate
    Control0..1
    TypeBackboneElement
    56. Composition.section:columnHeaders.section:effectEstimate.code
    58. Composition.section:columnHeaders.section:effectEstimate.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "result-with-intervention-vs-comparator",
      "display" : "Result with intervention vs. comparator"
    }
    60. Composition.section:columnHeaders.section:netEffectContribution
    Slice NamenetEffectContribution
    Control1..1
    TypeBackboneElement
    Must Supporttrue
    62. Composition.section:columnHeaders.section:netEffectContribution.code
    64. Composition.section:columnHeaders.section:netEffectContribution.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "net-effect-contribution",
      "display" : "Net Effect Contribution"
    }
    66. Composition.section:outcomeEntry
    Slice NameoutcomeEntry
    Control1..*
    Must Supporttrue
    68. Composition.section:outcomeEntry.code
    70. Composition.section:outcomeEntry.code.coding
    Control1..1
    Pattern Value{
      "system" : "https://fevir.net/resources/CodeSystem/179423",
      "code" : "summary-of-net-effect-contributions-entry-for-a-single-outcome",
      "display" : "Summary of net effect contributions entry for a single outcome"
    }
    72. Composition.section:outcomeEntry.focus
    TypeReference(VariableDefinition)
    74. Composition.section:outcomeEntry.section
    Control1..?
    SlicingThis element introduces a set of slices on Composition.section.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ code.coding
    • 76. Composition.section:outcomeEntry.section:outcomeDefinition
      Slice NameoutcomeDefinition
      Control0..1
      TypeBackboneElement
      78. Composition.section:outcomeEntry.section:outcomeDefinition.code
      80. Composition.section:outcomeEntry.section:outcomeDefinition.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "outcome-measure",
        "display" : "Outcome Measure"
      }
      82. Composition.section:outcomeEntry.section:outcomeDefinition.entry
      Control0..1
      TypeReference(VariableDefinition)
      84. Composition.section:outcomeEntry.section:outcomeDesirability
      Slice NameoutcomeDesirability
      Control0..1
      TypeBackboneElement
      86. Composition.section:outcomeEntry.section:outcomeDesirability.code
      88. Composition.section:outcomeEntry.section:outcomeDesirability.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "outcome-desirability",
        "display" : "Outcome Desirability"
      }
      90. Composition.section:outcomeEntry.section:outcomeDesirability.entry
      Control0..1
      TypeReference(OutcomeImportance)
      92. Composition.section:outcomeEntry.section:relativeImportance
      Slice NamerelativeImportance
      Control0..1
      TypeBackboneElement
      94. Composition.section:outcomeEntry.section:relativeImportance.code
      96. Composition.section:outcomeEntry.section:relativeImportance.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "relative-importance",
        "display" : "Relative Importance"
      }
      98. Composition.section:outcomeEntry.section:relativeImportance.entry
      Control0..1
      TypeReference(OutcomeImportance)
      100. Composition.section:outcomeEntry.section:resultWithoutTreatment
      Slice NameresultWithoutTreatment
      Control0..1
      TypeBackboneElement
      102. Composition.section:outcomeEntry.section:resultWithoutTreatment.code
      104. Composition.section:outcomeEntry.section:resultWithoutTreatment.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "result-with-comparator-alone",
        "display" : "Result with comparator alone"
      }
      106. Composition.section:outcomeEntry.section:resultWithoutTreatment.entry
      Control0..1
      TypeReference(ComparatorOnlyEvidence)
      108. Composition.section:outcomeEntry.section:resultWithTreatmentObserved
      Slice NameresultWithTreatmentObserved
      Control0..1
      TypeBackboneElement
      110. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.code
      112. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.code.coding
      Control1..1
      Pattern Value{
        "system" : "http://hl7.org/fhir/evidence-report-section",
        "code" : "Intervention-group-alone-Evidence",
        "display" : "Evidence Results for the intervention exposure only"
      }
      114. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.entry
      Control0..1
      TypeReference(InterventionOnlyEvidence)
      116. Composition.section:outcomeEntry.section:resultWithTreatmentDerived
      Slice NameresultWithTreatmentDerived
      Control0..1
      TypeBackboneElement
      118. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.code
      120. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "result-with-intervention-alone-calculated",
        "display" : "Result with intervention alone (calculated)"
      }
      122. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.entry
      Control0..2
      TypeReference(ComparatorOnlyEvidence, ComparativeEvidence)
      124. Composition.section:outcomeEntry.section:effectEstimate
      Slice NameeffectEstimate
      Control0..1
      TypeBackboneElement
      126. Composition.section:outcomeEntry.section:effectEstimate.code
      128. Composition.section:outcomeEntry.section:effectEstimate.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "result-with-intervention-vs-comparator",
        "display" : "Result with intervention vs. comparator"
      }
      130. Composition.section:outcomeEntry.section:effectEstimate.entry
      Control0..1
      TypeReference(ComparativeEvidence)
      132. Composition.section:outcomeEntry.section:netEffectContribution
      Slice NamenetEffectContribution
      Control1..1
      TypeBackboneElement
      Must Supporttrue
      134. Composition.section:outcomeEntry.section:netEffectContribution.code
      136. Composition.section:outcomeEntry.section:netEffectContribution.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "net-effect-contribution",
        "display" : "Net Effect Contribution"
      }
      138. Composition.section:outcomeEntry.section:netEffectContribution.entry
      Control0..1
      TypeReference(NetEffectContribution)
      140. Composition.section:netEffectEstimate
      Slice NamenetEffectEstimate
      Control0..1
      142. Composition.section:netEffectEstimate.code
      144. Composition.section:netEffectEstimate.code.coding
      Control1..1
      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "net-effect-estimate",
        "display" : "Net Effect Estimate"
      }
      146. Composition.section:netEffectEstimate.entry
      Control0..1
      TypeReference(NetEffectEstimate)

      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
      Must Supportfalse
      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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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 its 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 its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Composition.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      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..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      6. Composition.extension:versionAlgorithm
      Slice NameversionAlgorithm
      Definition

      Indicates the mechanism used to compare versions to determine which is more current.

      ShortHow to compare versions
      Comments

      If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

      Control0..1
      TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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. Composition.extension:experimental
      Slice Nameexperimental
      Definition

      A Boolean value to indicate that this artifact is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

      ShortFor testing purposes, not real usage
      Control0..1
      TypeExtension(Artifact Experimental) (Extension Type: boolean)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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:description
      Slice Namedescription
      Definition

      A free text natural language description of the artifact from a consumer's perspective.

      ShortNatural language description of the artifact
      Comments

      This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the artifact as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the artifact is presumed to be the predominant language in the place the artifact was created).

      Control0..1
      TypeExtension(Artifact Description) (Extension Type: markdown)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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:purpose
      Slice Namepurpose
      Definition

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

      ShortWhy this artifact is defined
      Comments

      This element does not describe the usage of the artifact. 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 artifact.

      Control0..1
      TypeExtension(Artifact Purpose) (Extension Type: markdown)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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:copyright
      Slice Namecopyright
      Definition

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

      ShortUse and/or publishing restrictions
      Comments

      The short copyright declaration (e.g. (c) '2015+ xyz organization' should be sent in the copyrightLabel element.

      Control0..1
      TypeExtension(Artifact Copyright) (Extension Type: markdown)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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: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 Supportfalse
      Invariantsele-1: All FHIR elements must have a @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:approvalDate
      Slice NameapprovalDate
      Definition

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

      ShortWhen the resource was approved by publisher
      Control0..1
      TypeExtension(ArtifactApprovalDate) (Extension Type: date)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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: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 resource was last reviewed by the publisher
      Control0..1
      TypeExtension(ArtifactLastReviewDate) (Extension Type: date)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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:effectivePeriod
      Slice NameeffectivePeriod
      Definition

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

      ShortWhen the resource is expected to be used
      Control0..1
      TypeExtension(ArtifactEffectivePeriod) (Extension Type: Period)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @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 managable, 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
      Must Supportfalse
      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
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Composition.status
      Definition

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

      Shortregistered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
      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|6.0.0-ballot2
      (required to http://hl7.org/fhir/ValueSet/composition-status|6.0.0-ballot2)

      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
      Must Supportfalse
      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()))
      28. Composition.type
      Definition

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

      ShortKind of composition (LOINC if possible)
      Comments

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

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

      Type of a composition.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      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()))
      30. Composition.type.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..1*
      TypeCoding
      Is Modifierfalse
      Summaryfalse
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "https://fevir.net/resources/CodeSystem/179423",
        "code" : "SummaryOfNetEffect",
        "display" : "SummaryOfNetEffect"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Composition.type.text
      Definition

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

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

      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

      Pattern ValueSummary of Net Effect Contributions
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. 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

      Reference a single Citation Resource, EvidenceVariable Resource (EvidenceReportSubject Profile), or ReserchStudy Resource to define the subject of this EvidenceReport.


      For clinical documents, this is usually the patient.

      Control0..1*
      TypeReference(Citation, Classification, EvidenceReportSubject, ResearchStudy, Resource)
      Is Modifierfalse
      Must Supportfalse
      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()))
      36. Composition.date
      Definition

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

      ShortComposition editing time
      Comments

      The Last Modified Date on the composition may be after the date of the document was attested without being changed. This means that the date on an amended document is the date of the amendment, not the date of original authorship.

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

      dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring this version of the Composition. 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 this version of the Composition. 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(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
      Is Modifierfalse
      Must Supportfalse
      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.

      ShortHuman Readable name/title
      Comments

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

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

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

      ShortRelationships to other compositions/documents
      Comments

      To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
      When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
      Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

      "relatesTo": [{
        "type": "replaces",
        "resourceReference": {
          "identifier": { 
            "system": "...", 
            "value": "..."
          }
        } 
      }]
      
      Control0..*
      TypeRelatedArtifact
      Is Modifierfalse
      Must Supportfalse
      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.relatesTo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ label
      • 44. Composition.relatesTo:citeAs
        Slice NameciteAs
        Definition

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

        ShortRelationships to other compositions/documents
        Comments

        To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
        When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
        Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

        "relatesTo": [{
          "type": "replaces",
          "resourceReference": {
            "identifier": { 
              "system": "...", 
              "value": "..."
            }
          } 
        }]
        
        Control0..1*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Composition.relatesTo:citeAs.type
        Definition

        The type of relationship to the related artifact.

        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
        Comments

        The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

        Control1..1
        BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2
        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

        The type of relationship to the related artifact.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern Valuecite-as
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Composition.relatesTo:citeAs.label
        Definition

        A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

        ShortShort label
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern ValueCite as
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Composition.relatesTo:partOf
        Slice NamepartOf
        Definition

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

        ShortRelationships to other compositions/documents
        Comments

        To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
        When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
        Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

        "relatesTo": [{
          "type": "replaces",
          "resourceReference": {
            "identifier": { 
              "system": "...", 
              "value": "..."
            }
          } 
        }]
        
        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Composition.relatesTo:partOf.type
        Definition

        The type of relationship to the related artifact.

        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
        Comments

        The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

        Control1..1
        BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2
        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

        The type of relationship to the related artifact.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern Valuepart-of
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Composition.relatesTo:partOf.label
        Definition

        A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

        ShortShort label
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern ValuePart of
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Composition.relatesTo:derivedFrom
        Slice NamederivedFrom
        Definition

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

        ShortRelationships to other compositions/documents
        Comments

        To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
        When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
        Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

        "relatesTo": [{
          "type": "replaces",
          "resourceReference": {
            "identifier": { 
              "system": "...", 
              "value": "..."
            }
          } 
        }]
        
        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Composition.relatesTo:derivedFrom.type
        Definition

        The type of relationship to the related artifact.

        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
        Comments

        The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

        Control1..1
        BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2
        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

        The type of relationship to the related artifact.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern Valuederived-from
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Composition.relatesTo:derivedFrom.label
        Definition

        A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

        ShortShort label
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern ValueDerived from
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Composition.relatesTo:specificationOfOriginal
        Slice NamespecificationOfOriginal
        Definition

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

        ShortRelationships to other compositions/documents
        Comments

        To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
        When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
        Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

        "relatesTo": [{
          "type": "replaces",
          "resourceReference": {
            "identifier": { 
              "system": "...", 
              "value": "..."
            }
          } 
        }]
        
        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Composition.relatesTo:specificationOfOriginal.type
        Definition

        The type of relationship to the related artifact.

        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
        Comments

        The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

        Control1..1
        BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2
        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

        The type of relationship to the related artifact.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern Valuespecification-of
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Composition.relatesTo:specificationOfOriginal.label
        Definition

        A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

        ShortShort label
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern ValueOriginal publication
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Composition.section
        Definition

        The root of the sections that make up the composition.

        ShortComposition is broken into sections
        Control20..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        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.coding
        • 70. 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 managable, 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()))
          72. 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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. Composition.section:introduction
          Slice Nameintroduction
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          76. Composition.section:introduction.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 managable, 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()))
          78. Composition.section:introduction.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Composition.section:discussion
          Slice Namediscussion
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          82. Composition.section:discussion.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 managable, 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()))
          84. Composition.section:discussion.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. Composition.section:methods
          Slice Namemethods
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          88. Composition.section:methods.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 managable, 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()))
          90. Composition.section:methods.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. Composition.section:references
          Slice Namereferences
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          94. Composition.section:references.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 managable, 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()))
          96. Composition.section:references.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-1, cmp-2
          TypeReference(Citation, Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. Composition.section:competingInterests
          Slice NamecompetingInterests
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          100. Composition.section:competingInterests.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 managable, 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()))
          102. Composition.section:competingInterests.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. Composition.section:acknowledgements
          Slice Nameacknowledgements
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          106. Composition.section:acknowledgements.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 managable, 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()))
          108. Composition.section:acknowledgements.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. Composition.section:appendices
          Slice Nameappendices
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          112. Composition.section:appendices.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 managable, 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()))
          114. Composition.section:appendices.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. Composition.section:columnHeaders
          Slice NamecolumnHeaders
          Definition

          The root of the sections that make up the composition.

          ShortComposition is broken into sections
          Control10..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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()))
          118. Composition.section:columnHeaders.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 managable, 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()))
          120. Composition.section:columnHeaders.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-1, cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. Composition.section:columnHeaders.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.

          Control20..*
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Must Supportfalse
          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.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ code.coding
          • 124. Composition.section:columnHeaders.section:outcomeDefinition
            Slice NameoutcomeDefinition
            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.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            126. Composition.section:columnHeaders.section:outcomeDefinition.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 managable, 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()))
            128. Composition.section:columnHeaders.section:outcomeDefinition.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            130. Composition.section:columnHeaders.section:outcomeDesirability
            Slice NameoutcomeDesirability
            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..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. Composition.section:columnHeaders.section:outcomeDesirability.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 managable, 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()))
            134. Composition.section:columnHeaders.section:outcomeDesirability.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Composition.section:columnHeaders.section:relativeImportance
            Slice NamerelativeImportance
            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..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            138. Composition.section:columnHeaders.section:relativeImportance.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 managable, 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()))
            140. Composition.section:columnHeaders.section:relativeImportance.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            142. Composition.section:columnHeaders.section:resultWithoutTreatment
            Slice NameresultWithoutTreatment
            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..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            144. Composition.section:columnHeaders.section:resultWithoutTreatment.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 managable, 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()))
            146. Composition.section:columnHeaders.section:resultWithoutTreatment.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. Composition.section:columnHeaders.section:resultWithTreatmentObserved
            Slice NameresultWithTreatmentObserved
            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..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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 managable, 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()))
            152. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            154. Composition.section:columnHeaders.section:resultWithTreatmentDerived
            Slice NameresultWithTreatmentDerived
            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..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            156. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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 managable, 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()))
            158. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            160. Composition.section:columnHeaders.section:effectEstimate
            Slice NameeffectEstimate
            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..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            162. Composition.section:columnHeaders.section:effectEstimate.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 managable, 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()))
            164. Composition.section:columnHeaders.section:effectEstimate.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            166. Composition.section:columnHeaders.section:netEffectContribution
            Slice NamenetEffectContribution
            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.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            168. Composition.section:columnHeaders.section:netEffectContribution.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 managable, 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()))
            170. Composition.section:columnHeaders.section:netEffectContribution.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            172. Composition.section:outcomeEntry
            Slice NameoutcomeEntry
            Definition

            The root of the sections that make up the composition.

            ShortComposition is broken into sections
            Control10..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            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()))
            174. Composition.section:outcomeEntry.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 managable, 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()))
            176. Composition.section:outcomeEntry.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(VariableDefinition, Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            178. Composition.section:outcomeEntry.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-1, cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            180. Composition.section:outcomeEntry.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.

            Control10..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
            Is Modifierfalse
            Must Supportfalse
            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.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ code.coding
            • 182. Composition.section:outcomeEntry.section:outcomeDefinition
              Slice NameoutcomeDefinition
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              184. Composition.section:outcomeEntry.section:outcomeDefinition.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 managable, 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()))
              186. Composition.section:outcomeEntry.section:outcomeDefinition.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(VariableDefinition, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              188. Composition.section:outcomeEntry.section:outcomeDesirability
              Slice NameoutcomeDesirability
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              190. Composition.section:outcomeEntry.section:outcomeDesirability.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 managable, 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()))
              192. Composition.section:outcomeEntry.section:outcomeDesirability.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(OutcomeImportance, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              194. Composition.section:outcomeEntry.section:relativeImportance
              Slice NamerelativeImportance
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              196. Composition.section:outcomeEntry.section:relativeImportance.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 managable, 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()))
              198. Composition.section:outcomeEntry.section:relativeImportance.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(OutcomeImportance, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              200. Composition.section:outcomeEntry.section:resultWithoutTreatment
              Slice NameresultWithoutTreatment
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              202. Composition.section:outcomeEntry.section:resultWithoutTreatment.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 managable, 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()))
              204. Composition.section:outcomeEntry.section:resultWithoutTreatment.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(ComparatorOnlyEvidence, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              206. Composition.section:outcomeEntry.section:resultWithTreatmentObserved
              Slice NameresultWithTreatmentObserved
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              208. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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 managable, 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()))
              210. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(InterventionOnlyEvidence, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              212. Composition.section:outcomeEntry.section:resultWithTreatmentDerived
              Slice NameresultWithTreatmentDerived
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              214. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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 managable, 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()))
              216. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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..2*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(ComparatorOnlyEvidence, ComparativeEvidence, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              218. Composition.section:outcomeEntry.section:effectEstimate
              Slice NameeffectEstimate
              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..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              220. Composition.section:outcomeEntry.section:effectEstimate.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 managable, 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()))
              222. Composition.section:outcomeEntry.section:effectEstimate.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(ComparativeEvidence, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              224. Composition.section:outcomeEntry.section:netEffectContribution
              Slice NamenetEffectContribution
              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.

              Control10..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              226. Composition.section:outcomeEntry.section:netEffectContribution.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 managable, 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()))
              228. Composition.section:outcomeEntry.section:netEffectContribution.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(NetEffectContribution, Resource)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              230. Composition.section:netEffectEstimate
              Slice NamenetEffectEstimate
              Definition

              The root of the sections that make up the composition.

              ShortComposition is broken into sections
              Control0..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              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()))
              232. Composition.section:netEffectEstimate.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 managable, 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()))
              234. Composition.section:netEffectEstimate.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..1*
              This element is affected by the following invariants: cmp-1, cmp-2
              TypeReference(NetEffectEstimate, Resource)
              Is Modifierfalse
              Must Supportfalse
              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
              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
              Must Supportfalse
              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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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

              Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

              Control0..1
              Typeid
              Is Modifierfalse
              Must Supportfalse
              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
              Must Supportfalse
              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 its 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 its meaning or interpretation
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              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 of the resource content
              Comments

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

              Control0..1
              BindingThe codes SHALL be taken from AllLanguages
              (required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot2)

              IETF language tag for a human language

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              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 a 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
              This element is affected by the following invariants: dom-6
              TypeNarrative
              Is Modifierfalse
              Must Supportfalse
              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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

              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..*
              This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
              TypeResource
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Alternate Namesinline resources, anonymous resources, contained resources
              14. Composition.extension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 16. Composition.extension:versionAlgorithm
                Slice NameversionAlgorithm
                Definition

                Indicates the mechanism used to compare versions to determine which is more current.

                ShortHow to compare versions
                Comments

                If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

                Control0..1
                TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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:experimental
                Slice Nameexperimental
                Definition

                A Boolean value to indicate that this artifact is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

                ShortFor testing purposes, not real usage
                Control0..1
                TypeExtension(Artifact Experimental) (Extension Type: boolean)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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:description
                Slice Namedescription
                Definition

                A free text natural language description of the artifact from a consumer's perspective.

                ShortNatural language description of the artifact
                Comments

                This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the artifact as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the artifact is presumed to be the predominant language in the place the artifact was created).

                Control0..1
                TypeExtension(Artifact Description) (Extension Type: markdown)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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:purpose
                Slice Namepurpose
                Definition

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

                ShortWhy this artifact is defined
                Comments

                This element does not describe the usage of the artifact. 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 artifact.

                Control0..1
                TypeExtension(Artifact Purpose) (Extension Type: markdown)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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:copyright
                Slice Namecopyright
                Definition

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

                ShortUse and/or publishing restrictions
                Comments

                The short copyright declaration (e.g. (c) '2015+ xyz organization' should be sent in the copyrightLabel element.

                Control0..1
                TypeExtension(Artifact Copyright) (Extension Type: markdown)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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: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 Supportfalse
                Invariantsele-1: All FHIR elements must have a @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:approvalDate
                Slice NameapprovalDate
                Definition

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

                ShortWhen the resource was approved by publisher
                Control0..1
                TypeExtension(ArtifactApprovalDate) (Extension Type: date)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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: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 resource was last reviewed by the publisher
                Control0..1
                TypeExtension(ArtifactLastReviewDate) (Extension Type: date)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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:effectivePeriod
                Slice NameeffectivePeriod
                Definition

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

                ShortWhen the resource is expected to be used
                Control0..1
                TypeExtension(ArtifactEffectivePeriod) (Extension Type: Period)
                Is Modifierfalse
                Must Supportfalse
                Invariantsele-1: All FHIR elements must have a @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 managable, 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
                Must Supportfalse
                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
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. Composition.url
                Definition

                An absolute URI that is used to identify this Composition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this Composition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the Composition is stored on different servers.

                ShortCanonical identifier for this Composition, represented as a URI (globally unique)
                Comments

                Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Requirements

                Allows the Composition to be referenced by a single globally unique identifier.

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

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

                ShortVersion-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)
                Control0..*
                TypeIdentifier
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. Composition.version
                Definition

                An explicitly assigned identifier of a variation of the content in the Composition.

                ShortAn explicitly assigned identifier of a variation of the content in the 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.

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. Composition.status
                Definition

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

                Shortregistered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
                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|6.0.0-ballot2)

                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
                Must Supportfalse
                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()))
                44. Composition.type
                Definition

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

                ShortKind of composition (LOINC if possible)
                Comments

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

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

                Type of a composition.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                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()))
                46. Composition.type.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                This element is affected by the following invariants: ele-1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                48. Composition.type.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 managable, 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()))
                SlicingThis element introduces a set of slices on Composition.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 50. Composition.type.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control1..1
                  TypeCoding
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Pattern Value{
                    "system" : "https://fevir.net/resources/CodeSystem/179423",
                    "code" : "SummaryOfNetEffect",
                    "display" : "SummaryOfNetEffect"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. Composition.type.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

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

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  Pattern ValueSummary of Net Effect Contributions
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. 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
                  Control0..*
                  BindingFor example codes, see ReferencedItemCategoryValueSet
                  (example to http://hl7.org/fhir/ValueSet/referenced-item-category)

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  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()))
                  56. 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

                  Reference a single Citation Resource, EvidenceVariable Resource (EvidenceReportSubject Profile), or ReserchStudy Resource to define the subject of this EvidenceReport.

                  Control0..1
                  TypeReference(Citation, Classification, EvidenceReportSubject, ResearchStudy)
                  Is Modifierfalse
                  Must Supportfalse
                  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()))
                  58. Composition.encounter
                  Definition

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

                  ShortContext of the Composition
                  Control0..1
                  TypeReference(Encounter)
                  Is Modifierfalse
                  Must Supportfalse
                  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()))
                  60. Composition.date
                  Definition

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

                  ShortComposition editing time
                  Comments

                  The Last Modified Date on the composition may be after the date of the document was attested without being changed. This means that the date on an amended document is the date of the amendment, not the date of original authorship.

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

                  dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring this version of the Composition. 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()))
                  62. Composition.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 Composition 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 Supportfalse
                  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()))
                  64. 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(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                  Is Modifierfalse
                  Must Supportfalse
                  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()))
                  66. Composition.name
                  Definition

                  A natural language name identifying the {{title}}. This name should be usable as an identifier for the module by machine processing applications such as code generation.

                  ShortName for this Composition (computer friendly)
                  Comments

                  The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

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

                  Support human navigation and code generation.

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

                  Official human-readable label for the composition.

                  ShortHuman Readable name/title
                  Comments

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

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

                  For any additional notes.

                  ShortFor any additional notes
                  Comments

                  A comment, general note or annotation not coded elsewhere.

                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. 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()))
                  74. 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
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  76. 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 managable, 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()))
                  78. 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 managable, 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()))
                  80. Composition.attester.mode
                  Definition

                  The type of attestation the authenticator offers.

                  Shortreviewer | editor | endorser | informant | recorder
                  Control1..1
                  BindingThe codes SHOULD be taken from Evidence Report Contributor Role Value Set
                  (preferred to http://hl7.org/fhir/uv/ebm/ValueSet/evidence-report-contributor-role)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  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()))
                  82. 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
                  Must Supportfalse
                  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()))
                  84. 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
                  Must Supportfalse
                  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()))
                  86. Composition.custodian
                  Definition

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

                  ShortOrganization which maintains the composition
                  Comments

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

                  Control0..1
                  TypeReference(Organization)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Requirements

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

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

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

                  ShortRelationships to other compositions/documents
                  Comments

                  To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
                  When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
                  Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

                  "relatesTo": [{
                    "type": "replaces",
                    "resourceReference": {
                      "identifier": { 
                        "system": "...", 
                        "value": "..."
                      }
                    } 
                  }]
                  
                  Control0..*
                  TypeRelatedArtifact
                  Is Modifierfalse
                  Must Supportfalse
                  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.relatesTo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ label
                  • 90. Composition.relatesTo:citeAs
                    Slice NameciteAs
                    Definition

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

                    ShortRelationships to other compositions/documents
                    Comments

                    To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
                    When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
                    Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

                    "relatesTo": [{
                      "type": "replaces",
                      "resourceReference": {
                        "identifier": { 
                          "system": "...", 
                          "value": "..."
                        }
                      } 
                    }]
                    
                    Control0..1
                    TypeRelatedArtifact
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    92. Composition.relatesTo:citeAs.id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    94. Composition.relatesTo:citeAs.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 managable, 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()))
                    SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 96. Composition.relatesTo:citeAs.type
                      Definition

                      The type of relationship to the related artifact.

                      Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
                      Comments

                      The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

                      Control1..1
                      BindingThe codes SHALL be taken from RelatedArtifactType
                      (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

                      The type of relationship to the related artifact.

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Pattern Valuecite-as
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      98. Composition.relatesTo:citeAs.classifier
                      Definition

                      Provides additional classifiers of the related artifact.

                      ShortAdditional classifiers
                      Control0..*
                      BindingFor example codes, see CitationArtifactClassifier
                      (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

                      Additional classifiers for the related artifact.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      100. Composition.relatesTo:citeAs.label
                      Definition

                      A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                      ShortShort label
                      Control1..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Pattern ValueCite as
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      102. Composition.relatesTo:citeAs.display
                      Definition

                      A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                      ShortBrief description of the related artifact
                      Control0..1
                      Typestring
                      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()))
                      104. Composition.relatesTo:citeAs.citation
                      Definition

                      A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                      ShortBibliographic citation for the artifact
                      Comments

                      Additional structured information about citations should be captured as extensions.

                      Control0..1
                      Typemarkdown
                      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()))
                      106. Composition.relatesTo:citeAs.document
                      Definition

                      The document being referenced, represented as an attachment. This is exclusive with the resource element.

                      ShortWhat document is being referenced
                      Control0..1
                      TypeAttachment
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. Composition.relatesTo:citeAs.resource
                      Definition

                      The related artifact, such as a library, value set, profile, or other knowledge resource.

                      ShortWhat artifact is being referenced
                      Comments

                      If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                      Control0..1
                      Typecanonical(Resource)
                      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()))
                      110. Composition.relatesTo:citeAs.resourceReference
                      Definition

                      The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

                      ShortWhat artifact, if not a conformance resource
                      Comments

                      If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

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

                      The publication status of the artifact being referred to.

                      Shortdraft | active | retired | unknown
                      Control0..1
                      BindingThe codes SHALL be taken from PublicationStatus
                      (required to http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot2)

                      Publication status of an artifact being referred to.

                      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()))
                      114. Composition.relatesTo:citeAs.publicationDate
                      Definition

                      The date of publication of the artifact being referred to.

                      ShortDate of publication of the artifact being referred to
                      Control0..1
                      Typedate
                      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()))
                      116. Composition.relatesTo:partOf
                      Slice NamepartOf
                      Definition

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

                      ShortRelationships to other compositions/documents
                      Comments

                      To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
                      When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
                      Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

                      "relatesTo": [{
                        "type": "replaces",
                        "resourceReference": {
                          "identifier": { 
                            "system": "...", 
                            "value": "..."
                          }
                        } 
                      }]
                      
                      Control0..*
                      TypeRelatedArtifact
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      118. Composition.relatesTo:partOf.id
                      Definition

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

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typeid
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      120. Composition.relatesTo:partOf.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 managable, 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()))
                      SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 122. Composition.relatesTo:partOf.type
                        Definition

                        The type of relationship to the related artifact.

                        Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
                        Comments

                        The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

                        Control1..1
                        BindingThe codes SHALL be taken from RelatedArtifactType
                        (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

                        The type of relationship to the related artifact.

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Pattern Valuepart-of
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        124. Composition.relatesTo:partOf.classifier
                        Definition

                        Provides additional classifiers of the related artifact.

                        ShortAdditional classifiers
                        Control0..*
                        BindingFor example codes, see CitationArtifactClassifier
                        (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

                        Additional classifiers for the related artifact.

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

                        A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                        ShortShort label
                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Pattern ValuePart of
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        128. Composition.relatesTo:partOf.display
                        Definition

                        A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                        ShortBrief description of the related artifact
                        Control0..1
                        Typestring
                        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()))
                        130. Composition.relatesTo:partOf.citation
                        Definition

                        A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                        ShortBibliographic citation for the artifact
                        Comments

                        Additional structured information about citations should be captured as extensions.

                        Control0..1
                        Typemarkdown
                        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()))
                        132. Composition.relatesTo:partOf.document
                        Definition

                        The document being referenced, represented as an attachment. This is exclusive with the resource element.

                        ShortWhat document is being referenced
                        Control0..1
                        TypeAttachment
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        134. Composition.relatesTo:partOf.resource
                        Definition

                        The related artifact, such as a library, value set, profile, or other knowledge resource.

                        ShortWhat artifact is being referenced
                        Comments

                        If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                        Control0..1
                        Typecanonical(Resource)
                        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()))
                        136. Composition.relatesTo:partOf.resourceReference
                        Definition

                        The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

                        ShortWhat artifact, if not a conformance resource
                        Comments

                        If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

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

                        The publication status of the artifact being referred to.

                        Shortdraft | active | retired | unknown
                        Control0..1
                        BindingThe codes SHALL be taken from PublicationStatus
                        (required to http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot2)

                        Publication status of an artifact being referred to.

                        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()))
                        140. Composition.relatesTo:partOf.publicationDate
                        Definition

                        The date of publication of the artifact being referred to.

                        ShortDate of publication of the artifact being referred to
                        Control0..1
                        Typedate
                        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()))
                        142. Composition.relatesTo:derivedFrom
                        Slice NamederivedFrom
                        Definition

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

                        ShortRelationships to other compositions/documents
                        Comments

                        To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
                        When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
                        Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

                        "relatesTo": [{
                          "type": "replaces",
                          "resourceReference": {
                            "identifier": { 
                              "system": "...", 
                              "value": "..."
                            }
                          } 
                        }]
                        
                        Control0..*
                        TypeRelatedArtifact
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        144. Composition.relatesTo:derivedFrom.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeid
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        146. Composition.relatesTo:derivedFrom.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 managable, 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()))
                        SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 148. Composition.relatesTo:derivedFrom.type
                          Definition

                          The type of relationship to the related artifact.

                          Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
                          Comments

                          The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

                          Control1..1
                          BindingThe codes SHALL be taken from RelatedArtifactType
                          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

                          The type of relationship to the related artifact.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Pattern Valuederived-from
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          150. Composition.relatesTo:derivedFrom.classifier
                          Definition

                          Provides additional classifiers of the related artifact.

                          ShortAdditional classifiers
                          Control0..*
                          BindingFor example codes, see CitationArtifactClassifier
                          (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

                          Additional classifiers for the related artifact.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          152. Composition.relatesTo:derivedFrom.label
                          Definition

                          A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                          ShortShort label
                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Pattern ValueDerived from
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          154. Composition.relatesTo:derivedFrom.display
                          Definition

                          A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                          ShortBrief description of the related artifact
                          Control0..1
                          Typestring
                          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()))
                          156. Composition.relatesTo:derivedFrom.citation
                          Definition

                          A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                          ShortBibliographic citation for the artifact
                          Comments

                          Additional structured information about citations should be captured as extensions.

                          Control0..1
                          Typemarkdown
                          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()))
                          158. Composition.relatesTo:derivedFrom.document
                          Definition

                          The document being referenced, represented as an attachment. This is exclusive with the resource element.

                          ShortWhat document is being referenced
                          Control0..1
                          TypeAttachment
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          160. Composition.relatesTo:derivedFrom.resource
                          Definition

                          The related artifact, such as a library, value set, profile, or other knowledge resource.

                          ShortWhat artifact is being referenced
                          Comments

                          If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                          Control0..1
                          Typecanonical(Resource)
                          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()))
                          162. Composition.relatesTo:derivedFrom.resourceReference
                          Definition

                          The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

                          ShortWhat artifact, if not a conformance resource
                          Comments

                          If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

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

                          The publication status of the artifact being referred to.

                          Shortdraft | active | retired | unknown
                          Control0..1
                          BindingThe codes SHALL be taken from PublicationStatus
                          (required to http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot2)

                          Publication status of an artifact being referred to.

                          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()))
                          166. Composition.relatesTo:derivedFrom.publicationDate
                          Definition

                          The date of publication of the artifact being referred to.

                          ShortDate of publication of the artifact being referred to
                          Control0..1
                          Typedate
                          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()))
                          168. Composition.relatesTo:specificationOfOriginal
                          Slice NamespecificationOfOriginal
                          Definition

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

                          ShortRelationships to other compositions/documents
                          Comments

                          To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a resourceReference with an identifier.
                          When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
                          Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

                          "relatesTo": [{
                            "type": "replaces",
                            "resourceReference": {
                              "identifier": { 
                                "system": "...", 
                                "value": "..."
                              }
                            } 
                          }]
                          
                          Control0..*
                          TypeRelatedArtifact
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          170. Composition.relatesTo:specificationOfOriginal.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typeid
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          172. Composition.relatesTo:specificationOfOriginal.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 managable, 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()))
                          SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 174. Composition.relatesTo:specificationOfOriginal.type
                            Definition

                            The type of relationship to the related artifact.

                            Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as
                            Comments

                            The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

                            Control1..1
                            BindingThe codes SHALL be taken from RelatedArtifactType
                            (required to http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot2)

                            The type of relationship to the related artifact.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Pattern Valuespecification-of
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            176. Composition.relatesTo:specificationOfOriginal.classifier
                            Definition

                            Provides additional classifiers of the related artifact.

                            ShortAdditional classifiers
                            Control0..*
                            BindingFor example codes, see CitationArtifactClassifier
                            (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

                            Additional classifiers for the related artifact.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            178. Composition.relatesTo:specificationOfOriginal.label
                            Definition

                            A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                            ShortShort label
                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Pattern ValueOriginal publication
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            180. Composition.relatesTo:specificationOfOriginal.display
                            Definition

                            A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                            ShortBrief description of the related artifact
                            Control0..1
                            Typestring
                            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()))
                            182. Composition.relatesTo:specificationOfOriginal.citation
                            Definition

                            A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                            ShortBibliographic citation for the artifact
                            Comments

                            Additional structured information about citations should be captured as extensions.

                            Control0..1
                            Typemarkdown
                            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()))
                            184. Composition.relatesTo:specificationOfOriginal.document
                            Definition

                            The document being referenced, represented as an attachment. This is exclusive with the resource element.

                            ShortWhat document is being referenced
                            Control0..1
                            TypeAttachment
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            186. Composition.relatesTo:specificationOfOriginal.resource
                            Definition

                            The related artifact, such as a library, value set, profile, or other knowledge resource.

                            ShortWhat artifact is being referenced
                            Comments

                            If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                            Control0..1
                            Typecanonical(Resource)
                            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()))
                            188. Composition.relatesTo:specificationOfOriginal.resourceReference
                            Definition

                            The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

                            ShortWhat artifact, if not a conformance resource
                            Comments

                            If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

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

                            The publication status of the artifact being referred to.

                            Shortdraft | active | retired | unknown
                            Control0..1
                            BindingThe codes SHALL be taken from PublicationStatus
                            (required to http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot2)

                            Publication status of an artifact being referred to.

                            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()))
                            192. Composition.relatesTo:specificationOfOriginal.publicationDate
                            Definition

                            The date of publication of the artifact being referred to.

                            ShortDate of publication of the artifact being referred to
                            Control0..1
                            Typedate
                            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()))
                            194. 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
                            Must Supportfalse
                            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()))
                            196. 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
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            198. 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 managable, 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()))
                            200. 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 managable, 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()))
                            202. 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
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            204. Composition.event.detail
                            Definition

                            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 case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to an other resource.

                            ShortThe event(s) being documented, as code(s), reference(s), or both
                            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 events 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.

                            TypeCodeableReference(Resource)
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            206. Composition.section
                            Definition

                            The root of the sections that make up the composition.

                            ShortComposition is broken into sections
                            Control2..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            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.coding
                            • 208. 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
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              210. 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 managable, 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()))
                              212. 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 managable, 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()))
                              214. 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
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              216. Composition.section.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
                              BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                              (extensible to https://fevir.net/resources/ValueSet/179431)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              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()))
                              218. 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
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Identifies who is responsible for the content.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              220. Composition.section.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
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              222. 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
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              224. 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
                              Must Supportfalse
                              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()))
                              226. 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-1, cmp-2
                              TypeReference(Resource)
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              228. 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
                              Must Supportfalse
                              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()))
                              230. 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..*
                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              232. Composition.section:introduction
                              Slice Nameintroduction
                              Definition

                              The root of the sections that make up the composition.

                              ShortComposition is broken into sections
                              Control0..1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              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()))
                              234. Composition.section:introduction.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              236. Composition.section:introduction.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 managable, 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()))
                              238. Composition.section:introduction.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 managable, 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()))
                              240. Composition.section:introduction.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
                              Must Supportfalse
                              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()))
                              242. Composition.section:introduction.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
                              BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                              (extensible to https://fevir.net/resources/ValueSet/179431)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              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()))
                              244. Composition.section:introduction.code.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typeid
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              246. Composition.section:introduction.code.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 managable, 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()))
                              SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 248. Composition.section:introduction.code.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control1..1
                                TypeCoding
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Allows for alternative encodings within a code system, and translations to other code systems.

                                Pattern Value{
                                  "system" : "https://fevir.net/resources/CodeSystem/179423",
                                  "code" : "introduction",
                                  "display" : "Introduction"
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                250. Composition.section:introduction.code.text
                                Definition

                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                ShortPlain text representation of the concept
                                Comments

                                Very often the text is the same as a displayName of one of the codings.

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

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                252. Composition.section:introduction.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
                                Must Supportfalse
                                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()))
                                254. Composition.section:introduction.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
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                256. Composition.section:introduction.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
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                258. Composition.section:introduction.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
                                Must Supportfalse
                                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()))
                                260. Composition.section:introduction.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-1, cmp-2
                                TypeReference(Resource)
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                262. Composition.section:introduction.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
                                Must Supportfalse
                                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()))
                                264. Composition.section:introduction.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..*
                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                266. Composition.section:discussion
                                Slice Namediscussion
                                Definition

                                The root of the sections that make up the composition.

                                ShortComposition is broken into sections
                                Control0..1
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supporttrue
                                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()))
                                268. Composition.section:discussion.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                270. Composition.section:discussion.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 managable, 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()))
                                272. Composition.section:discussion.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 managable, 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()))
                                274. Composition.section:discussion.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
                                Must Supportfalse
                                Summaryfalse
                                Requirements

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

                                Alternate Namesheader, label, caption
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                276. Composition.section:discussion.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
                                BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                (extensible to https://fevir.net/resources/ValueSet/179431)
                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                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()))
                                278. Composition.section:discussion.code.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                280. Composition.section:discussion.code.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 managable, 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()))
                                SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 282. Composition.section:discussion.code.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control1..1
                                  TypeCoding
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Pattern Value{
                                    "system" : "https://fevir.net/resources/CodeSystem/179423",
                                    "code" : "discussion",
                                    "display" : "Discussion"
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  284. Composition.section:discussion.code.text
                                  Definition

                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                  ShortPlain text representation of the concept
                                  Comments

                                  Very often the text is the same as a displayName of one of the codings.

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

                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  286. Composition.section:discussion.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
                                  Must Supportfalse
                                  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()))
                                  288. Composition.section:discussion.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
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  290. Composition.section:discussion.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
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  292. Composition.section:discussion.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
                                  Must Supportfalse
                                  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()))
                                  294. Composition.section:discussion.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-1, cmp-2
                                  TypeReference(Resource)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  296. Composition.section:discussion.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
                                  Must Supportfalse
                                  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()))
                                  298. Composition.section:discussion.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..*
                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  300. Composition.section:methods
                                  Slice Namemethods
                                  Definition

                                  The root of the sections that make up the composition.

                                  ShortComposition is broken into sections
                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  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()))
                                  302. Composition.section:methods.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  304. Composition.section:methods.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 managable, 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()))
                                  306. Composition.section:methods.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 managable, 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()))
                                  308. Composition.section:methods.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
                                  Must Supportfalse
                                  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()))
                                  310. Composition.section:methods.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
                                  BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                  (extensible to https://fevir.net/resources/ValueSet/179431)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  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()))
                                  312. Composition.section:methods.code.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  314. Composition.section:methods.code.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 managable, 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()))
                                  SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 316. Composition.section:methods.code.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control1..1
                                    TypeCoding
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Pattern Value{
                                      "system" : "https://fevir.net/resources/CodeSystem/179423",
                                      "code" : "methods",
                                      "display" : "Methods"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    318. Composition.section:methods.code.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

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

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    320. Composition.section:methods.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
                                    Must Supportfalse
                                    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()))
                                    322. Composition.section:methods.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
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    324. Composition.section:methods.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
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    326. Composition.section:methods.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
                                    Must Supportfalse
                                    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()))
                                    328. Composition.section:methods.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-1, cmp-2
                                    TypeReference(Resource)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    330. Composition.section:methods.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
                                    Must Supportfalse
                                    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()))
                                    332. Composition.section:methods.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..*
                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    334. Composition.section:references
                                    Slice Namereferences
                                    Definition

                                    The root of the sections that make up the composition.

                                    ShortComposition is broken into sections
                                    Control0..1
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    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()))
                                    336. Composition.section:references.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    338. Composition.section:references.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 managable, 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()))
                                    340. Composition.section:references.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 managable, 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()))
                                    342. Composition.section:references.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
                                    Must Supportfalse
                                    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()))
                                    344. Composition.section:references.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
                                    BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                    (extensible to https://fevir.net/resources/ValueSet/179431)
                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    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()))
                                    346. Composition.section:references.code.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typeid
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    348. Composition.section:references.code.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 managable, 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()))
                                    SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 350. Composition.section:references.code.coding
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control1..1
                                      TypeCoding
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Pattern Value{
                                        "system" : "https://fevir.net/resources/CodeSystem/179423",
                                        "code" : "references",
                                        "display" : "References"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      352. Composition.section:references.code.text
                                      Definition

                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                      ShortPlain text representation of the concept
                                      Comments

                                      Very often the text is the same as a displayName of one of the codings.

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

                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      354. Composition.section:references.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
                                      Must Supportfalse
                                      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:references.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
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      358. Composition.section:references.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
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      360. Composition.section:references.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
                                      Must Supportfalse
                                      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()))
                                      362. Composition.section:references.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-1, cmp-2
                                      TypeReference(Citation)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      364. Composition.section:references.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
                                      Must Supportfalse
                                      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()))
                                      366. Composition.section:references.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..*
                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      368. Composition.section:competingInterests
                                      Slice NamecompetingInterests
                                      Definition

                                      The root of the sections that make up the composition.

                                      ShortComposition is broken into sections
                                      Control0..1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      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()))
                                      370. Composition.section:competingInterests.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      372. Composition.section:competingInterests.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 managable, 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()))
                                      374. Composition.section:competingInterests.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 managable, 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()))
                                      376. Composition.section:competingInterests.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
                                      Must Supportfalse
                                      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()))
                                      378. Composition.section:competingInterests.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
                                      BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                      (extensible to https://fevir.net/resources/ValueSet/179431)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      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()))
                                      380. Composition.section:competingInterests.code.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      382. Composition.section:competingInterests.code.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 managable, 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()))
                                      SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 384. Composition.section:competingInterests.code.coding
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control1..1
                                        TypeCoding
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Pattern Value{
                                          "system" : "https://fevir.net/resources/CodeSystem/179423",
                                          "code" : "competing-interests",
                                          "display" : "Competing Interests"
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        386. Composition.section:competingInterests.code.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

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

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        388. Composition.section:competingInterests.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
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Identifies who is responsible for the content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        390. Composition.section:competingInterests.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
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        392. Composition.section:competingInterests.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
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        394. Composition.section:competingInterests.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
                                        Must Supportfalse
                                        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()))
                                        396. Composition.section:competingInterests.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-1, cmp-2
                                        TypeReference(Resource)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        398. Composition.section:competingInterests.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
                                        Must Supportfalse
                                        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:competingInterests.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..*
                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        402. Composition.section:acknowledgements
                                        Slice Nameacknowledgements
                                        Definition

                                        The root of the sections that make up the composition.

                                        ShortComposition is broken into sections
                                        Control0..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        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()))
                                        404. Composition.section:acknowledgements.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        406. Composition.section:acknowledgements.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 managable, 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()))
                                        408. Composition.section:acknowledgements.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 managable, 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()))
                                        410. Composition.section:acknowledgements.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
                                        Must Supportfalse
                                        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:acknowledgements.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
                                        BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                        (extensible to https://fevir.net/resources/ValueSet/179431)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        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()))
                                        414. Composition.section:acknowledgements.code.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeid
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        416. Composition.section:acknowledgements.code.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 managable, 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()))
                                        SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 418. Composition.section:acknowledgements.code.coding
                                          Definition

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                          Control1..1
                                          TypeCoding
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Pattern Value{
                                            "system" : "https://fevir.net/resources/CodeSystem/179423",
                                            "code" : "acknowledgements",
                                            "display" : "Acknowledgements"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          420. Composition.section:acknowledgements.code.text
                                          Definition

                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                          ShortPlain text representation of the concept
                                          Comments

                                          Very often the text is the same as a displayName of one of the codings.

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

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          422. Composition.section:acknowledgements.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
                                          Must Supportfalse
                                          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()))
                                          424. Composition.section:acknowledgements.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
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          426. Composition.section:acknowledgements.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
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          428. Composition.section:acknowledgements.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
                                          Must Supportfalse
                                          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()))
                                          430. Composition.section:acknowledgements.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-1, cmp-2
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          432. Composition.section:acknowledgements.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
                                          Must Supportfalse
                                          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()))
                                          434. Composition.section:acknowledgements.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..*
                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          436. Composition.section:appendices
                                          Slice Nameappendices
                                          Definition

                                          The root of the sections that make up the composition.

                                          ShortComposition is broken into sections
                                          Control0..1
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          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()))
                                          438. Composition.section:appendices.id
                                          Definition

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          440. Composition.section:appendices.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 managable, 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()))
                                          442. Composition.section:appendices.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 managable, 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()))
                                          444. Composition.section:appendices.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
                                          Must Supportfalse
                                          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()))
                                          446. Composition.section:appendices.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
                                          BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                          (extensible to https://fevir.net/resources/ValueSet/179431)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          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()))
                                          448. Composition.section:appendices.code.id
                                          Definition

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          450. Composition.section:appendices.code.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 managable, 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()))
                                          SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 452. Composition.section:appendices.code.coding
                                            Definition

                                            A reference to a code defined by a terminology system.

                                            ShortCode defined by a terminology system
                                            Comments

                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                            Control1..1
                                            TypeCoding
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                            Pattern Value{
                                              "system" : "https://fevir.net/resources/CodeSystem/179423",
                                              "code" : "appendices",
                                              "display" : "Appendices"
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            454. Composition.section:appendices.code.text
                                            Definition

                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                            ShortPlain text representation of the concept
                                            Comments

                                            Very often the text is the same as a displayName of one of the codings.

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

                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            456. Composition.section:appendices.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
                                            Must Supportfalse
                                            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()))
                                            458. Composition.section:appendices.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
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            460. Composition.section:appendices.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
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            462. Composition.section:appendices.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
                                            Must Supportfalse
                                            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()))
                                            464. Composition.section:appendices.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-1, cmp-2
                                            TypeReference(Resource)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            466. Composition.section:appendices.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
                                            Must Supportfalse
                                            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()))
                                            468. Composition.section:appendices.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..*
                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            470. Composition.section:columnHeaders
                                            Slice NamecolumnHeaders
                                            Definition

                                            The root of the sections that make up the composition.

                                            ShortComposition is broken into sections
                                            Control1..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supporttrue
                                            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()))
                                            472. Composition.section:columnHeaders.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            474. Composition.section:columnHeaders.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 managable, 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()))
                                            476. Composition.section:columnHeaders.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 managable, 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()))
                                            478. Composition.section:columnHeaders.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
                                            Must Supportfalse
                                            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()))
                                            480. Composition.section:columnHeaders.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
                                            BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                            (extensible to https://fevir.net/resources/ValueSet/179431)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            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()))
                                            482. Composition.section:columnHeaders.code.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            484. Composition.section:columnHeaders.code.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 managable, 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()))
                                            SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 486. Composition.section:columnHeaders.code.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                              Control1..1
                                              TypeCoding
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                              Pattern Value{
                                                "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                "code" : "column-headers",
                                                "display" : "Column Headers"
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              488. Composition.section:columnHeaders.code.text
                                              Definition

                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                              ShortPlain text representation of the concept
                                              Comments

                                              Very often the text is the same as a displayName of one of the codings.

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

                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              490. Composition.section:columnHeaders.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
                                              Must Supportfalse
                                              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()))
                                              492. Composition.section:columnHeaders.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
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              494. Composition.section:columnHeaders.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
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              496. Composition.section:columnHeaders.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
                                              Must Supportfalse
                                              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()))
                                              498. Composition.section:columnHeaders.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-1, cmp-2
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              500. Composition.section:columnHeaders.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
                                              Must Supportfalse
                                              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()))
                                              502. Composition.section:columnHeaders.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.

                                              Control2..*
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Must Supportfalse
                                              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.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ code.coding
                                              • 504. Composition.section:columnHeaders.section:outcomeDefinition
                                                Slice NameoutcomeDefinition
                                                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.

                                                Control1..1
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                506. Composition.section:columnHeaders.section:outcomeDefinition.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                508. Composition.section:columnHeaders.section:outcomeDefinition.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 managable, 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()))
                                                510. Composition.section:columnHeaders.section:outcomeDefinition.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 managable, 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()))
                                                512. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                Must Supportfalse
                                                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()))
                                                514. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                Must Supportfalse
                                                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()))
                                                516. Composition.section:columnHeaders.section:outcomeDefinition.code.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                518. Composition.section:columnHeaders.section:outcomeDefinition.code.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 managable, 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()))
                                                SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 520. Composition.section:columnHeaders.section:outcomeDefinition.code.coding
                                                  Definition

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode defined by a terminology system
                                                  Comments

                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                  Control1..1
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                  Pattern Value{
                                                    "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                    "code" : "outcome-measure",
                                                    "display" : "Outcome Measure"
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  522. Composition.section:columnHeaders.section:outcomeDefinition.code.text
                                                  Definition

                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                  ShortPlain text representation of the concept
                                                  Comments

                                                  Very often the text is the same as a displayName of one of the codings.

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

                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  524. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                  Must Supportfalse
                                                  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()))
                                                  526. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  528. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  530. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                  Must Supportfalse
                                                  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()))
                                                  532. Composition.section:columnHeaders.section:outcomeDefinition.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-1, cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  534. Composition.section:columnHeaders.section:outcomeDefinition.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
                                                  Must Supportfalse
                                                  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()))
                                                  536. Composition.section:columnHeaders.section:outcomeDefinition.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..*
                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  538. Composition.section:columnHeaders.section:outcomeDesirability
                                                  Slice NameoutcomeDesirability
                                                  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..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  540. Composition.section:columnHeaders.section:outcomeDesirability.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  542. Composition.section:columnHeaders.section:outcomeDesirability.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 managable, 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()))
                                                  544. Composition.section:columnHeaders.section:outcomeDesirability.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 managable, 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()))
                                                  546. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                  Must Supportfalse
                                                  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()))
                                                  548. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                  Must Supportfalse
                                                  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()))
                                                  550. Composition.section:columnHeaders.section:outcomeDesirability.code.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typeid
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  552. Composition.section:columnHeaders.section:outcomeDesirability.code.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 managable, 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()))
                                                  SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 554. Composition.section:columnHeaders.section:outcomeDesirability.code.coding
                                                    Definition

                                                    A reference to a code defined by a terminology system.

                                                    ShortCode defined by a terminology system
                                                    Comments

                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                    Control1..1
                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                                    Pattern Value{
                                                      "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                      "code" : "outcome-desirability",
                                                      "display" : "Outcome Desirability"
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    556. Composition.section:columnHeaders.section:outcomeDesirability.code.text
                                                    Definition

                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                    ShortPlain text representation of the concept
                                                    Comments

                                                    Very often the text is the same as a displayName of one of the codings.

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

                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    558. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                    Must Supportfalse
                                                    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()))
                                                    560. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    562. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    564. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                    Must Supportfalse
                                                    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()))
                                                    566. Composition.section:columnHeaders.section:outcomeDesirability.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-1, cmp-2
                                                    TypeReference(Resource)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    568. Composition.section:columnHeaders.section:outcomeDesirability.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
                                                    Must Supportfalse
                                                    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()))
                                                    570. Composition.section:columnHeaders.section:outcomeDesirability.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..*
                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    572. Composition.section:columnHeaders.section:relativeImportance
                                                    Slice NamerelativeImportance
                                                    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..1
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    574. Composition.section:columnHeaders.section:relativeImportance.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    576. Composition.section:columnHeaders.section:relativeImportance.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 managable, 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()))
                                                    578. Composition.section:columnHeaders.section:relativeImportance.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 managable, 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()))
                                                    580. Composition.section:columnHeaders.section:relativeImportance.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
                                                    Must Supportfalse
                                                    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()))
                                                    582. Composition.section:columnHeaders.section:relativeImportance.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
                                                    Must Supportfalse
                                                    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()))
                                                    584. Composition.section:columnHeaders.section:relativeImportance.code.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typeid
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    586. Composition.section:columnHeaders.section:relativeImportance.code.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 managable, 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()))
                                                    SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 588. Composition.section:columnHeaders.section:relativeImportance.code.coding
                                                      Definition

                                                      A reference to a code defined by a terminology system.

                                                      ShortCode defined by a terminology system
                                                      Comments

                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                      Control1..1
                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                      Pattern Value{
                                                        "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                        "code" : "relative-importance",
                                                        "display" : "Relative Importance"
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      590. Composition.section:columnHeaders.section:relativeImportance.code.text
                                                      Definition

                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                      ShortPlain text representation of the concept
                                                      Comments

                                                      Very often the text is the same as a displayName of one of the codings.

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

                                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      592. Composition.section:columnHeaders.section:relativeImportance.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
                                                      Must Supportfalse
                                                      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()))
                                                      594. Composition.section:columnHeaders.section:relativeImportance.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
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      596. Composition.section:columnHeaders.section:relativeImportance.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
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      598. Composition.section:columnHeaders.section:relativeImportance.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
                                                      Must Supportfalse
                                                      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:columnHeaders.section:relativeImportance.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-1, cmp-2
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      602. Composition.section:columnHeaders.section:relativeImportance.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
                                                      Must Supportfalse
                                                      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:columnHeaders.section:relativeImportance.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..*
                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      606. Composition.section:columnHeaders.section:resultWithoutTreatment
                                                      Slice NameresultWithoutTreatment
                                                      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..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      608. Composition.section:columnHeaders.section:resultWithoutTreatment.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      610. Composition.section:columnHeaders.section:resultWithoutTreatment.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 managable, 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()))
                                                      612. Composition.section:columnHeaders.section:resultWithoutTreatment.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 managable, 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()))
                                                      614. Composition.section:columnHeaders.section:resultWithoutTreatment.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
                                                      Must Supportfalse
                                                      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:columnHeaders.section:resultWithoutTreatment.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
                                                      Must Supportfalse
                                                      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()))
                                                      618. Composition.section:columnHeaders.section:resultWithoutTreatment.code.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeid
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      620. Composition.section:columnHeaders.section:resultWithoutTreatment.code.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 managable, 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()))
                                                      SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 622. Composition.section:columnHeaders.section:resultWithoutTreatment.code.coding
                                                        Definition

                                                        A reference to a code defined by a terminology system.

                                                        ShortCode defined by a terminology system
                                                        Comments

                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                        Control1..1
                                                        TypeCoding
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                        Pattern Value{
                                                          "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                          "code" : "result-with-comparator-alone",
                                                          "display" : "Result with comparator alone"
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        624. Composition.section:columnHeaders.section:resultWithoutTreatment.code.text
                                                        Definition

                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                        ShortPlain text representation of the concept
                                                        Comments

                                                        Very often the text is the same as a displayName of one of the codings.

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

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        626. Composition.section:columnHeaders.section:resultWithoutTreatment.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
                                                        Must Supportfalse
                                                        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()))
                                                        628. Composition.section:columnHeaders.section:resultWithoutTreatment.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
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        630. Composition.section:columnHeaders.section:resultWithoutTreatment.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
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        632. Composition.section:columnHeaders.section:resultWithoutTreatment.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
                                                        Must Supportfalse
                                                        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()))
                                                        634. Composition.section:columnHeaders.section:resultWithoutTreatment.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-1, cmp-2
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        636. Composition.section:columnHeaders.section:resultWithoutTreatment.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
                                                        Must Supportfalse
                                                        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()))
                                                        638. Composition.section:columnHeaders.section:resultWithoutTreatment.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..*
                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        640. Composition.section:columnHeaders.section:resultWithTreatmentObserved
                                                        Slice NameresultWithTreatmentObserved
                                                        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..1
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        642. Composition.section:columnHeaders.section:resultWithTreatmentObserved.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        644. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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 managable, 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()))
                                                        646. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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 managable, 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()))
                                                        648. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                        Must Supportfalse
                                                        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()))
                                                        650. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                        Must Supportfalse
                                                        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()))
                                                        652. Composition.section:columnHeaders.section:resultWithTreatmentObserved.code.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typeid
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        654. Composition.section:columnHeaders.section:resultWithTreatmentObserved.code.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 managable, 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()))
                                                        SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 656. Composition.section:columnHeaders.section:resultWithTreatmentObserved.code.coding
                                                          Definition

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode defined by a terminology system
                                                          Comments

                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                          Control1..1
                                                          TypeCoding
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                          Pattern Value{
                                                            "system" : "http://hl7.org/fhir/evidence-report-section",
                                                            "code" : "Intervention-group-alone-Evidence",
                                                            "display" : "Evidence Results for the intervention exposure only"
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          658. Composition.section:columnHeaders.section:resultWithTreatmentObserved.code.text
                                                          Definition

                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                          ShortPlain text representation of the concept
                                                          Comments

                                                          Very often the text is the same as a displayName of one of the codings.

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

                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          660. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                          Must Supportfalse
                                                          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()))
                                                          662. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          664. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          666. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                          Must Supportfalse
                                                          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()))
                                                          668. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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-1, cmp-2
                                                          TypeReference(Resource)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          670. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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
                                                          Must Supportfalse
                                                          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()))
                                                          672. Composition.section:columnHeaders.section:resultWithTreatmentObserved.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..*
                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          674. Composition.section:columnHeaders.section:resultWithTreatmentDerived
                                                          Slice NameresultWithTreatmentDerived
                                                          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..1
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          676. Composition.section:columnHeaders.section:resultWithTreatmentDerived.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          678. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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 managable, 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()))
                                                          680. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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 managable, 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()))
                                                          682. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                          Must Supportfalse
                                                          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()))
                                                          684. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                          Must Supportfalse
                                                          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()))
                                                          686. Composition.section:columnHeaders.section:resultWithTreatmentDerived.code.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typeid
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          688. Composition.section:columnHeaders.section:resultWithTreatmentDerived.code.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 managable, 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()))
                                                          SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 690. Composition.section:columnHeaders.section:resultWithTreatmentDerived.code.coding
                                                            Definition

                                                            A reference to a code defined by a terminology system.

                                                            ShortCode defined by a terminology system
                                                            Comments

                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                            Control1..1
                                                            TypeCoding
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                            Pattern Value{
                                                              "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                              "code" : "result-with-intervention-alone-calculated",
                                                              "display" : "Result with intervention alone (calculated)"
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            692. Composition.section:columnHeaders.section:resultWithTreatmentDerived.code.text
                                                            Definition

                                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                            ShortPlain text representation of the concept
                                                            Comments

                                                            Very often the text is the same as a displayName of one of the codings.

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

                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            694. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                            Must Supportfalse
                                                            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()))
                                                            696. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            698. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            700. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                            Must Supportfalse
                                                            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()))
                                                            702. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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-1, cmp-2
                                                            TypeReference(Resource)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            704. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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
                                                            Must Supportfalse
                                                            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()))
                                                            706. Composition.section:columnHeaders.section:resultWithTreatmentDerived.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..*
                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            708. Composition.section:columnHeaders.section:effectEstimate
                                                            Slice NameeffectEstimate
                                                            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..1
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            710. Composition.section:columnHeaders.section:effectEstimate.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            712. Composition.section:columnHeaders.section:effectEstimate.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 managable, 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()))
                                                            714. Composition.section:columnHeaders.section:effectEstimate.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 managable, 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()))
                                                            716. Composition.section:columnHeaders.section:effectEstimate.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
                                                            Must Supportfalse
                                                            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()))
                                                            718. Composition.section:columnHeaders.section:effectEstimate.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
                                                            Must Supportfalse
                                                            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()))
                                                            720. Composition.section:columnHeaders.section:effectEstimate.code.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            722. Composition.section:columnHeaders.section:effectEstimate.code.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 managable, 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()))
                                                            SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 724. Composition.section:columnHeaders.section:effectEstimate.code.coding
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                              Control1..1
                                                              TypeCoding
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                              Pattern Value{
                                                                "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                "code" : "result-with-intervention-vs-comparator",
                                                                "display" : "Result with intervention vs. comparator"
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              726. Composition.section:columnHeaders.section:effectEstimate.code.text
                                                              Definition

                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                              ShortPlain text representation of the concept
                                                              Comments

                                                              Very often the text is the same as a displayName of one of the codings.

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

                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              728. Composition.section:columnHeaders.section:effectEstimate.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
                                                              Must Supportfalse
                                                              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()))
                                                              730. Composition.section:columnHeaders.section:effectEstimate.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
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              732. Composition.section:columnHeaders.section:effectEstimate.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
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              734. Composition.section:columnHeaders.section:effectEstimate.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
                                                              Must Supportfalse
                                                              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()))
                                                              736. Composition.section:columnHeaders.section:effectEstimate.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-1, cmp-2
                                                              TypeReference(Resource)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              738. Composition.section:columnHeaders.section:effectEstimate.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
                                                              Must Supportfalse
                                                              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()))
                                                              740. Composition.section:columnHeaders.section:effectEstimate.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..*
                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              742. Composition.section:columnHeaders.section:netEffectContribution
                                                              Slice NamenetEffectContribution
                                                              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.

                                                              Control1..1
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              744. Composition.section:columnHeaders.section:netEffectContribution.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              746. Composition.section:columnHeaders.section:netEffectContribution.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 managable, 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()))
                                                              748. Composition.section:columnHeaders.section:netEffectContribution.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 managable, 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()))
                                                              750. Composition.section:columnHeaders.section:netEffectContribution.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
                                                              Must Supportfalse
                                                              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()))
                                                              752. Composition.section:columnHeaders.section:netEffectContribution.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
                                                              Must Supportfalse
                                                              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()))
                                                              754. Composition.section:columnHeaders.section:netEffectContribution.code.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typeid
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              756. Composition.section:columnHeaders.section:netEffectContribution.code.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 managable, 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()))
                                                              SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 758. Composition.section:columnHeaders.section:netEffectContribution.code.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                Control1..1
                                                                TypeCoding
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                Pattern Value{
                                                                  "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                  "code" : "net-effect-contribution",
                                                                  "display" : "Net Effect Contribution"
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                760. Composition.section:columnHeaders.section:netEffectContribution.code.text
                                                                Definition

                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                ShortPlain text representation of the concept
                                                                Comments

                                                                Very often the text is the same as a displayName of one of the codings.

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

                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                762. Composition.section:columnHeaders.section:netEffectContribution.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
                                                                Must Supportfalse
                                                                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()))
                                                                764. Composition.section:columnHeaders.section:netEffectContribution.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
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                766. Composition.section:columnHeaders.section:netEffectContribution.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
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                768. Composition.section:columnHeaders.section:netEffectContribution.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
                                                                Must Supportfalse
                                                                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()))
                                                                770. Composition.section:columnHeaders.section:netEffectContribution.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-1, cmp-2
                                                                TypeReference(Resource)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                772. Composition.section:columnHeaders.section:netEffectContribution.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
                                                                Must Supportfalse
                                                                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()))
                                                                774. Composition.section:columnHeaders.section:netEffectContribution.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..*
                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                776. Composition.section:outcomeEntry
                                                                Slice NameoutcomeEntry
                                                                Definition

                                                                The root of the sections that make up the composition.

                                                                ShortComposition is broken into sections
                                                                Control1..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                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()))
                                                                778. Composition.section:outcomeEntry.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                780. Composition.section:outcomeEntry.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 managable, 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()))
                                                                782. Composition.section:outcomeEntry.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 managable, 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()))
                                                                784. Composition.section:outcomeEntry.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
                                                                Must Supportfalse
                                                                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()))
                                                                786. Composition.section:outcomeEntry.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
                                                                BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                                                (extensible to https://fevir.net/resources/ValueSet/179431)
                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                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()))
                                                                788. Composition.section:outcomeEntry.code.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typeid
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                790. Composition.section:outcomeEntry.code.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 managable, 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()))
                                                                SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 792. Composition.section:outcomeEntry.code.coding
                                                                  Definition

                                                                  A reference to a code defined by a terminology system.

                                                                  ShortCode defined by a terminology system
                                                                  Comments

                                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                  Control1..1
                                                                  TypeCoding
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                  Pattern Value{
                                                                    "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                    "code" : "summary-of-net-effect-contributions-entry-for-a-single-outcome",
                                                                    "display" : "Summary of net effect contributions entry for a single outcome"
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  794. Composition.section:outcomeEntry.code.text
                                                                  Definition

                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                  ShortPlain text representation of the concept
                                                                  Comments

                                                                  Very often the text is the same as a displayName of one of the codings.

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

                                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  796. Composition.section:outcomeEntry.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
                                                                  Must Supportfalse
                                                                  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()))
                                                                  798. Composition.section:outcomeEntry.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(VariableDefinition)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  800. Composition.section:outcomeEntry.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
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  802. Composition.section:outcomeEntry.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
                                                                  Must Supportfalse
                                                                  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()))
                                                                  804. Composition.section:outcomeEntry.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-1, cmp-2
                                                                  TypeReference(Resource)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  806. Composition.section:outcomeEntry.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
                                                                  Must Supportfalse
                                                                  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()))
                                                                  808. Composition.section:outcomeEntry.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.

                                                                  Control1..*
                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  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.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ code.coding
                                                                  • 810. Composition.section:outcomeEntry.section:outcomeDefinition
                                                                    Slice NameoutcomeDefinition
                                                                    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..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    812. Composition.section:outcomeEntry.section:outcomeDefinition.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    814. Composition.section:outcomeEntry.section:outcomeDefinition.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 managable, 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()))
                                                                    816. Composition.section:outcomeEntry.section:outcomeDefinition.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 managable, 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()))
                                                                    818. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                    Must Supportfalse
                                                                    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()))
                                                                    820. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                    Must Supportfalse
                                                                    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()))
                                                                    822. Composition.section:outcomeEntry.section:outcomeDefinition.code.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typeid
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    824. Composition.section:outcomeEntry.section:outcomeDefinition.code.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 managable, 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()))
                                                                    SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 826. Composition.section:outcomeEntry.section:outcomeDefinition.code.coding
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

                                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                      Control1..1
                                                                      TypeCoding
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                      Pattern Value{
                                                                        "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                        "code" : "outcome-measure",
                                                                        "display" : "Outcome Measure"
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      828. Composition.section:outcomeEntry.section:outcomeDefinition.code.text
                                                                      Definition

                                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                      ShortPlain text representation of the concept
                                                                      Comments

                                                                      Very often the text is the same as a displayName of one of the codings.

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

                                                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      830. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                      Must Supportfalse
                                                                      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()))
                                                                      832. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      834. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      836. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

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

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      838. Composition.section:outcomeEntry.section:outcomeDefinition.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..1
                                                                      This element is affected by the following invariants: cmp-1, cmp-2
                                                                      TypeReference(VariableDefinition)
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      840. Composition.section:outcomeEntry.section:outcomeDefinition.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
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

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

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      842. Composition.section:outcomeEntry.section:outcomeDefinition.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..*
                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      844. Composition.section:outcomeEntry.section:outcomeDesirability
                                                                      Slice NameoutcomeDesirability
                                                                      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..1
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      846. Composition.section:outcomeEntry.section:outcomeDesirability.id
                                                                      Definition

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

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      848. Composition.section:outcomeEntry.section:outcomeDesirability.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 managable, 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()))
                                                                      850. Composition.section:outcomeEntry.section:outcomeDesirability.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 managable, 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()))
                                                                      852. Composition.section:outcomeEntry.section:outcomeDesirability.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
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

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

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

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

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typeid
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      858. Composition.section:outcomeEntry.section:outcomeDesirability.code.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 managable, 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()))
                                                                      SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 860. Composition.section:outcomeEntry.section:outcomeDesirability.code.coding
                                                                        Definition

                                                                        A reference to a code defined by a terminology system.

                                                                        ShortCode defined by a terminology system
                                                                        Comments

                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                        Control1..1
                                                                        TypeCoding
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                        Pattern Value{
                                                                          "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                          "code" : "outcome-desirability",
                                                                          "display" : "Outcome Desirability"
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        862. Composition.section:outcomeEntry.section:outcomeDesirability.code.text
                                                                        Definition

                                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                        ShortPlain text representation of the concept
                                                                        Comments

                                                                        Very often the text is the same as a displayName of one of the codings.

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

                                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        864. Composition.section:outcomeEntry.section:outcomeDesirability.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
                                                                        Must Supportfalse
                                                                        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()))
                                                                        866. Composition.section:outcomeEntry.section:outcomeDesirability.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
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        868. Composition.section:outcomeEntry.section:outcomeDesirability.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
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        870. Composition.section:outcomeEntry.section:outcomeDesirability.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
                                                                        Must Supportfalse
                                                                        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()))
                                                                        872. Composition.section:outcomeEntry.section:outcomeDesirability.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..1
                                                                        This element is affected by the following invariants: cmp-1, cmp-2
                                                                        TypeReference(OutcomeImportance)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        874. Composition.section:outcomeEntry.section:outcomeDesirability.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
                                                                        Must Supportfalse
                                                                        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()))
                                                                        876. Composition.section:outcomeEntry.section:outcomeDesirability.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..*
                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        878. Composition.section:outcomeEntry.section:relativeImportance
                                                                        Slice NamerelativeImportance
                                                                        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..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        880. Composition.section:outcomeEntry.section:relativeImportance.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        882. Composition.section:outcomeEntry.section:relativeImportance.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 managable, 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()))
                                                                        884. Composition.section:outcomeEntry.section:relativeImportance.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 managable, 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()))
                                                                        886. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                        Must Supportfalse
                                                                        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()))
                                                                        888. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                        Must Supportfalse
                                                                        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()))
                                                                        890. Composition.section:outcomeEntry.section:relativeImportance.code.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typeid
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        892. Composition.section:outcomeEntry.section:relativeImportance.code.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 managable, 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()))
                                                                        SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 894. Composition.section:outcomeEntry.section:relativeImportance.code.coding
                                                                          Definition

                                                                          A reference to a code defined by a terminology system.

                                                                          ShortCode defined by a terminology system
                                                                          Comments

                                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                          Control1..1
                                                                          TypeCoding
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                          Pattern Value{
                                                                            "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                            "code" : "relative-importance",
                                                                            "display" : "Relative Importance"
                                                                          }
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          896. Composition.section:outcomeEntry.section:relativeImportance.code.text
                                                                          Definition

                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                          ShortPlain text representation of the concept
                                                                          Comments

                                                                          Very often the text is the same as a displayName of one of the codings.

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

                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          898. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                          Must Supportfalse
                                                                          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()))
                                                                          900. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          902. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          904. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                          Must Supportfalse
                                                                          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()))
                                                                          906. Composition.section:outcomeEntry.section:relativeImportance.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..1
                                                                          This element is affected by the following invariants: cmp-1, cmp-2
                                                                          TypeReference(OutcomeImportance)
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          908. Composition.section:outcomeEntry.section:relativeImportance.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
                                                                          Must Supportfalse
                                                                          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()))
                                                                          910. Composition.section:outcomeEntry.section:relativeImportance.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..*
                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          912. Composition.section:outcomeEntry.section:resultWithoutTreatment
                                                                          Slice NameresultWithoutTreatment
                                                                          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..1
                                                                          TypeBackboneElement
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          914. Composition.section:outcomeEntry.section:resultWithoutTreatment.id
                                                                          Definition

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

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          916. Composition.section:outcomeEntry.section:resultWithoutTreatment.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 managable, 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()))
                                                                          918. Composition.section:outcomeEntry.section:resultWithoutTreatment.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 managable, 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()))
                                                                          920. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                          Must Supportfalse
                                                                          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()))
                                                                          922. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                          Must Supportfalse
                                                                          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()))
                                                                          924. Composition.section:outcomeEntry.section:resultWithoutTreatment.code.id
                                                                          Definition

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

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typeid
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          926. Composition.section:outcomeEntry.section:resultWithoutTreatment.code.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 managable, 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()))
                                                                          SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 928. Composition.section:outcomeEntry.section:resultWithoutTreatment.code.coding
                                                                            Definition

                                                                            A reference to a code defined by a terminology system.

                                                                            ShortCode defined by a terminology system
                                                                            Comments

                                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                            Control1..1
                                                                            TypeCoding
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                                            Pattern Value{
                                                                              "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                              "code" : "result-with-comparator-alone",
                                                                              "display" : "Result with comparator alone"
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            930. Composition.section:outcomeEntry.section:resultWithoutTreatment.code.text
                                                                            Definition

                                                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                            ShortPlain text representation of the concept
                                                                            Comments

                                                                            Very often the text is the same as a displayName of one of the codings.

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

                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            932. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                            Must Supportfalse
                                                                            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()))
                                                                            934. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            936. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            938. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                            Must Supportfalse
                                                                            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()))
                                                                            940. Composition.section:outcomeEntry.section:resultWithoutTreatment.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..1
                                                                            This element is affected by the following invariants: cmp-1, cmp-2
                                                                            TypeReference(ComparatorOnlyEvidence)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            942. Composition.section:outcomeEntry.section:resultWithoutTreatment.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
                                                                            Must Supportfalse
                                                                            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()))
                                                                            944. Composition.section:outcomeEntry.section:resultWithoutTreatment.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..*
                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            946. Composition.section:outcomeEntry.section:resultWithTreatmentObserved
                                                                            Slice NameresultWithTreatmentObserved
                                                                            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..1
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            948. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            950. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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 managable, 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()))
                                                                            952. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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 managable, 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()))
                                                                            954. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                            Must Supportfalse
                                                                            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()))
                                                                            956. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                            Must Supportfalse
                                                                            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()))
                                                                            958. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.code.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typeid
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            960. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.code.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 managable, 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()))
                                                                            SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 962. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.code.coding
                                                                              Definition

                                                                              A reference to a code defined by a terminology system.

                                                                              ShortCode defined by a terminology system
                                                                              Comments

                                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                              Control1..1
                                                                              TypeCoding
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                                              Pattern Value{
                                                                                "system" : "http://hl7.org/fhir/evidence-report-section",
                                                                                "code" : "Intervention-group-alone-Evidence",
                                                                                "display" : "Evidence Results for the intervention exposure only"
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              964. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.code.text
                                                                              Definition

                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                              ShortPlain text representation of the concept
                                                                              Comments

                                                                              Very often the text is the same as a displayName of one of the codings.

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

                                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              966. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                              Must Supportfalse
                                                                              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()))
                                                                              968. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              970. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              972. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                              Must Supportfalse
                                                                              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()))
                                                                              974. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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..1
                                                                              This element is affected by the following invariants: cmp-1, cmp-2
                                                                              TypeReference(InterventionOnlyEvidence)
                                                                              Is Modifierfalse
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              976. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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
                                                                              Must Supportfalse
                                                                              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()))
                                                                              978. Composition.section:outcomeEntry.section:resultWithTreatmentObserved.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..*
                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                              Is Modifierfalse
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              980. Composition.section:outcomeEntry.section:resultWithTreatmentDerived
                                                                              Slice NameresultWithTreatmentDerived
                                                                              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..1
                                                                              TypeBackboneElement
                                                                              Is Modifierfalse
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              982. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.id
                                                                              Definition

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

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              984. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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 managable, 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()))
                                                                              986. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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 managable, 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()))
                                                                              988. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                              Must Supportfalse
                                                                              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()))
                                                                              990. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                              Must Supportfalse
                                                                              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()))
                                                                              992. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.code.id
                                                                              Definition

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

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typeid
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              994. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.code.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 managable, 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()))
                                                                              SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 996. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.code.coding
                                                                                Definition

                                                                                A reference to a code defined by a terminology system.

                                                                                ShortCode defined by a terminology system
                                                                                Comments

                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                Control1..1
                                                                                TypeCoding
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                Pattern Value{
                                                                                  "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                                  "code" : "result-with-intervention-alone-calculated",
                                                                                  "display" : "Result with intervention alone (calculated)"
                                                                                }
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                998. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.code.text
                                                                                Definition

                                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                ShortPlain text representation of the concept
                                                                                Comments

                                                                                Very often the text is the same as a displayName of one of the codings.

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

                                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                1000. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                                Must Supportfalse
                                                                                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()))
                                                                                1002. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                1004. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                1006. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                                Must Supportfalse
                                                                                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()))
                                                                                1008. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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..2
                                                                                This element is affected by the following invariants: cmp-1, cmp-2
                                                                                TypeReference(ComparatorOnlyEvidence, ComparativeEvidence)
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                1010. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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
                                                                                Must Supportfalse
                                                                                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()))
                                                                                1012. Composition.section:outcomeEntry.section:resultWithTreatmentDerived.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..*
                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                1014. Composition.section:outcomeEntry.section:effectEstimate
                                                                                Slice NameeffectEstimate
                                                                                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..1
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                1016. Composition.section:outcomeEntry.section:effectEstimate.id
                                                                                Definition

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

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                1018. Composition.section:outcomeEntry.section:effectEstimate.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 managable, 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()))
                                                                                1020. Composition.section:outcomeEntry.section:effectEstimate.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 managable, 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()))
                                                                                1022. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                Must Supportfalse
                                                                                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()))
                                                                                1024. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                Must Supportfalse
                                                                                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()))
                                                                                1026. Composition.section:outcomeEntry.section:effectEstimate.code.id
                                                                                Definition

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

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                Typeid
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                1028. Composition.section:outcomeEntry.section:effectEstimate.code.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 managable, 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()))
                                                                                SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 1030. Composition.section:outcomeEntry.section:effectEstimate.code.coding
                                                                                  Definition

                                                                                  A reference to a code defined by a terminology system.

                                                                                  ShortCode defined by a terminology system
                                                                                  Comments

                                                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                  Control1..1
                                                                                  TypeCoding
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                  Pattern Value{
                                                                                    "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                                    "code" : "result-with-intervention-vs-comparator",
                                                                                    "display" : "Result with intervention vs. comparator"
                                                                                  }
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1032. Composition.section:outcomeEntry.section:effectEstimate.code.text
                                                                                  Definition

                                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                  ShortPlain text representation of the concept
                                                                                  Comments

                                                                                  Very often the text is the same as a displayName of one of the codings.

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

                                                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1034. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                  Must Supportfalse
                                                                                  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()))
                                                                                  1036. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                  Must Supportfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1038. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                  Must Supportfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1040. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                  Must Supportfalse
                                                                                  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()))
                                                                                  1042. Composition.section:outcomeEntry.section:effectEstimate.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..1
                                                                                  This element is affected by the following invariants: cmp-1, cmp-2
                                                                                  TypeReference(ComparativeEvidence)
                                                                                  Is Modifierfalse
                                                                                  Must Supportfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1044. Composition.section:outcomeEntry.section:effectEstimate.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
                                                                                  Must Supportfalse
                                                                                  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()))
                                                                                  1046. Composition.section:outcomeEntry.section:effectEstimate.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..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                  Is Modifierfalse
                                                                                  Must Supportfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1048. Composition.section:outcomeEntry.section:netEffectContribution
                                                                                  Slice NamenetEffectContribution
                                                                                  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.

                                                                                  Control1..1
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  1050. Composition.section:outcomeEntry.section:netEffectContribution.id
                                                                                  Definition

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

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  1052. Composition.section:outcomeEntry.section:netEffectContribution.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 managable, 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()))
                                                                                  1054. Composition.section:outcomeEntry.section:netEffectContribution.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 managable, 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()))
                                                                                  1056. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                  Must Supportfalse
                                                                                  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()))
                                                                                  1058. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                  Must Supportfalse
                                                                                  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()))
                                                                                  1060. Composition.section:outcomeEntry.section:netEffectContribution.code.id
                                                                                  Definition

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

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typeid
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  1062. Composition.section:outcomeEntry.section:netEffectContribution.code.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 managable, 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()))
                                                                                  SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 1064. Composition.section:outcomeEntry.section:netEffectContribution.code.coding
                                                                                    Definition

                                                                                    A reference to a code defined by a terminology system.

                                                                                    ShortCode defined by a terminology system
                                                                                    Comments

                                                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                    Control1..1
                                                                                    TypeCoding
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                    Pattern Value{
                                                                                      "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                                      "code" : "net-effect-contribution",
                                                                                      "display" : "Net Effect Contribution"
                                                                                    }
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    1066. Composition.section:outcomeEntry.section:netEffectContribution.code.text
                                                                                    Definition

                                                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                    ShortPlain text representation of the concept
                                                                                    Comments

                                                                                    Very often the text is the same as a displayName of one of the codings.

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

                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    1068. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                    Must Supportfalse
                                                                                    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()))
                                                                                    1070. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                    Must Supportfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    1072. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                    Must Supportfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    1074. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                    Must Supportfalse
                                                                                    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()))
                                                                                    1076. Composition.section:outcomeEntry.section:netEffectContribution.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..1
                                                                                    This element is affected by the following invariants: cmp-1, cmp-2
                                                                                    TypeReference(NetEffectContribution)
                                                                                    Is Modifierfalse
                                                                                    Must Supportfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    1078. Composition.section:outcomeEntry.section:netEffectContribution.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
                                                                                    Must Supportfalse
                                                                                    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()))
                                                                                    1080. Composition.section:outcomeEntry.section:netEffectContribution.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..*
                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                    Is Modifierfalse
                                                                                    Must Supportfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    1082. Composition.section:netEffectEstimate
                                                                                    Slice NamenetEffectEstimate
                                                                                    Definition

                                                                                    The root of the sections that make up the composition.

                                                                                    ShortComposition is broken into sections
                                                                                    Control0..1
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Must Supportfalse
                                                                                    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()))
                                                                                    1084. Composition.section:netEffectEstimate.id
                                                                                    Definition

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

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    1086. Composition.section:netEffectEstimate.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 managable, 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()))
                                                                                    1088. Composition.section:netEffectEstimate.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 managable, 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()))
                                                                                    1090. Composition.section:netEffectEstimate.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
                                                                                    Must Supportfalse
                                                                                    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()))
                                                                                    1092. Composition.section:netEffectEstimate.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
                                                                                    BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
                                                                                    (extensible to https://fevir.net/resources/ValueSet/179431)
                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Must Supportfalse
                                                                                    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()))
                                                                                    1094. Composition.section:netEffectEstimate.code.id
                                                                                    Definition

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

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typeid
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    1096. Composition.section:netEffectEstimate.code.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 managable, 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()))
                                                                                    SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 1098. Composition.section:netEffectEstimate.code.coding
                                                                                      Definition

                                                                                      A reference to a code defined by a terminology system.

                                                                                      ShortCode defined by a terminology system
                                                                                      Comments

                                                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                      Control1..1
                                                                                      TypeCoding
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                      Pattern Value{
                                                                                        "system" : "https://fevir.net/resources/CodeSystem/179423",
                                                                                        "code" : "net-effect-estimate",
                                                                                        "display" : "Net Effect Estimate"
                                                                                      }
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      1100. Composition.section:netEffectEstimate.code.text
                                                                                      Definition

                                                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                      ShortPlain text representation of the concept
                                                                                      Comments

                                                                                      Very often the text is the same as a displayName of one of the codings.

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

                                                                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      1102. Composition.section:netEffectEstimate.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
                                                                                      Must Supportfalse
                                                                                      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()))
                                                                                      1104. Composition.section:netEffectEstimate.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
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      1106. Composition.section:netEffectEstimate.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
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      1108. Composition.section:netEffectEstimate.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
                                                                                      Must Supportfalse
                                                                                      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()))
                                                                                      1110. Composition.section:netEffectEstimate.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..1
                                                                                      This element is affected by the following invariants: cmp-1, cmp-2
                                                                                      TypeReference(NetEffectEstimate)
                                                                                      Is Modifierfalse
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      1112. Composition.section:netEffectEstimate.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
                                                                                      Must Supportfalse
                                                                                      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()))
                                                                                      1114. Composition.section:netEffectEstimate.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..*
                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                      Is Modifierfalse
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))