ChangeMade
type: StructureDefinition
node role: treeRoot
id:
  v: ChangeMade
language:
  v: en
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition ChangeMade Language: en Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> <a href="StructureDefinition-ChangeMade-definitions.html#Extension" title="Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions.">Extension 0..* Extension Change Made #xD; extension 2..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:change 1..1 Extension Annotation of a change. #xD; extension 0..0 Extension #xD; url 1..1 uri "change" #xD; value[x] 1..1 Annotation Value of extension #xD; extension:version-changed 1..1 Extension Version of Document Bundle produced by preceeding version of Compsition. This points to the Document Bundle and not the Composition, as the Document Bundle represents a static document. Intermediate versioning changes to Composition are expected to be handled in a different manner. #xD; extension 0..0 Extension #xD; url 1..1 uri "version-changed" #xD; value[x] 1..1 Reference(Bundle) Value of extension #xD; url 1..1 uri "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade" #xD; value[x] 0..0 Value of extension #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
    l: structuredefinition-wg
  value: Code
    v: sd
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
    l: structuredefinition-standards-status
  value: Code
    v: informative
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/uv/fhir-clinical-document/ImplementationGuide/hl7.fhir.uv.fhir-clinical-document
        l: hl7.fhir.uv.fhir-clinical-document
url:
  v: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
  l: ChangeMade
version:
  v: 1.1.0
name:
  v: ChangeMade
title:
  v: Change Made
status:
  v: active
experimental:
  v: true
date:
  v: 2026-06-10T12:45:56+00:00
publisher:
  v: HL7 International / Structured Documents
contact:
  name:
    v: HL7 International / Structured Documents
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/structure
  telecom:
    system:
      v: email
description:
  v: Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions.
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
    display:
      v: World
copyright:
  v: Used by permission of HL7 International, all rights reserved Creative Commons License
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
kind:
  v: complex-type
abstract:
  v: false
context:
  type:
    v: element
  expression:
    v: Composition
type:
  v: Extension
  l: Extension
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Extension
  l: Extension
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: Extension
    path:
      v: Extension
    short:
      v: Change Made
    definition:
      v: Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Extension
      min:
        v: 0
      max:
        v: *
    condition:
      v: ele-1
    constraint:
      key:
        v: ele-1
      severity:
        v: error
      human:
        v: All FHIR elements must have a @value or children
      expression:
        v: hasValue() or (children().count() > id.count())
      xpath:
        v: @value|f:*|h:div
      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        l: Element
    constraint:
      key:
        v: ext-1
      severity:
        v: error
      human:
        v: Must have either extensions or value[x], not both
      expression:
        v: extension.exists() != value.exists()
      xpath:
        v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
      source:
        v: http://hl7.org/fhir/StructureDefinition/Extension
        l: Extension
    is modifier:
      v: false
  element:
    id:
      v: Extension.id
    path:
      v: Extension.id
    representation:
      v: xmlAttr
    short:
      v: Unique id for inter-element referencing
    definition:
      v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: Element.id
      min:
        v: 0
      max:
        v: 1
    type:
      extension:
        value: Url
      code:
        v: http://hl7.org/fhirpath/System.String
        l: System.String
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: n/a
  element:
    id:
      v: Extension.extension
    path:
      v: Extension.extension
    slicing:
      description:
        v: Extensions are always sliced by (at least) url
      rules:
        v: open

Url
v: string
l: string

v: value

v: url

v: Extension

v: An Extension

v: 2

v: *

path:
  v: Element.extension
min:
  v: 0
max:
  v: *

code:
  v: Extension
  l: Extension

key:
  v: ele-1
severity:
  v: error
human:
  v: All FHIR elements must have a @value or children
expression:
  v: hasValue() or (children().count() > id.count())
xpath:
  v: @value|f:*|h:div
source:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element

key:
  v: ext-1
severity:
  v: error
human:
  v: Must have either extensions or value[x], not both
expression:
  v: extension.exists() != value.exists()
xpath:
  v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
source:
  v: http://hl7.org/fhir/StructureDefinition/Extension
  l: Extension

v: false

v: false

id:
  v: Extension.extension:change
path:
  v: Extension.extension
slice name:
  v: change
short:
  v: Annotation of a change.
definition:
  v: An Extension
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:change.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:change.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:change.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: change
  l: change
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:change.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Annotation
    l: Annotation
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:version-changed
path:
  v: Extension.extension
slice name:
  v: version-changed
short:
  v: Version of Document Bundle produced by preceeding version of Compsition. This points to the Document Bundle and not the Composition, as the Document Bundle represents a static document. Intermediate versioning changes to Composition are expected to be handled in a different manner.
definition:
  v: An Extension
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:version-changed.id
path:
  v: Extension.extension.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:version-changed.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: Extension.extension:version-changed.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: version-changed
  l: version-changed
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:version-changed.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Bundle
    l: Bundle
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.url
path:
  v: Extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
  l: ChangeMade
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.value[x]
path:
  v: Extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
min:
  v: 0
max:
  v: 0
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: base64Binary
    l: base64Binary
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: canonical
    l: canonical
type:
  code:
    v: code
    l: code
type:
  code:
    v: date
    l: date
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: decimal
    l: decimal
type:
  code:
    v: id
    l: id
type:
  code:
    v: instant
    l: instant
type:
  code:
    v: integer
    l: integer
type:
  code:
    v: markdown
    l: markdown
type:
  code:
    v: oid
    l: oid
type:
  code:
    v: positiveInt
    l: positiveInt
type:
  code:
    v: string
    l: string
type:
  code:
    v: time
    l: time
type:
  code:
    v: unsignedInt
    l: unsignedInt
type:
  code:
    v: uri
    l: uri
type:
  code:
    v: url
    l: url
type:
  code:
    v: uuid
    l: uuid
type:
  code:
    v: Address
    l: Address
type:
  code:
    v: Age
    l: Age
type:
  code:
    v: Annotation
    l: Annotation
type:
  code:
    v: Attachment
    l: Attachment
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: Coding
    l: Coding
type:
  code:
    v: ContactPoint
    l: ContactPoint
type:
  code:
    v: Count
    l: Count
type:
  code:
    v: Distance
    l: Distance
type:
  code:
    v: Duration
    l: Duration
type:
  code:
    v: HumanName
    l: HumanName
type:
  code:
    v: Identifier
    l: Identifier
type:
  code:
    v: Money
    l: Money
type:
  code:
    v: Period
    l: Period
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: Ratio
    l: Ratio
type:
  code:
    v: Reference
    l: Reference
type:
  code:
    v: SampledData
    l: SampledData
type:
  code:
    v: Signature
    l: Signature
type:
  code:
    v: Timing
    l: Timing
type:
  code:
    v: ContactDetail
    l: ContactDetail
type:
  code:
    v: Contributor
    l: Contributor
type:
  code:
    v: DataRequirement
    l: DataRequirement
type:
  code:
    v: Expression
    l: Expression
type:
  code:
    v: ParameterDefinition
    l: ParameterDefinition
type:
  code:
    v: RelatedArtifact
    l: RelatedArtifact

code:
  v: TriggerDefinition
  l: TriggerDefinition

code:
  v: UsageContext
  l: UsageContext

code:
  v: Dosage
  l: Dosage

code:
  v: Meta
  l: Meta

key:
  v: ele-1
severity:
  v: error
human:
  v: All FHIR elements must have a @value or children
expression:
  v: hasValue() or (children().count() > id.count())
xpath:
  v: @value|f:*|h:div
source:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element

v: false

v: false

identity:
  v: rim
map:
  v: N/A

element:
  id:
    v: Extension
  path:
    v: Extension
  short:
    v: Change Made
  definition:
    v: Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions.
element:
  id:
    v: Extension.extension
  path:
    v: Extension.extension
  min:
    v: 2
element:
  id:
    v: Extension.extension:change
  path:
    v: Extension.extension
  slice name:
    v: change
  short:
    v: Annotation of a change.
  min:
    v: 1
  max:
    v: 1
element:
  id:
    v: Extension.extension:change.extension
  path:
    v: Extension.extension.extension
  max:
    v: 0
element:
  id:
    v: Extension.extension:change.url
  path:
    v: Extension.extension.url
  fixed: Uri
    v: change
    l: change
element:
  id:
    v: Extension.extension:change.value[x]
  path:
    v: Extension.extension.value[x]
  min:
    v: 1
  type:
    code:
      v: Annotation
      l: Annotation
element:
  id:
    v: Extension.extension:version-changed
  path:
    v: Extension.extension
  slice name:
    v: version-changed
  short:
    v: Version of Document Bundle produced by preceeding version of Compsition. This points to the Document Bundle and not the Composition, as the Document Bundle represents a static document. Intermediate versioning changes to Composition are expected to be handled in a different manner.
  min:
    v: 1
  max:
    v: 1
element:
  id:
    v: Extension.extension:version-changed.extension
  path:
    v: Extension.extension.extension
  max:
    v: 0
element:
  id:
    v: Extension.extension:version-changed.url
  path:
    v: Extension.extension.url
  fixed: Uri
    v: version-changed
    l: version-changed
element:
  id:
    v: Extension.extension:version-changed.value[x]
  path:
    v: Extension.extension.value[x]
  min:
    v: 1
  type:
    code:
      v: Reference
      l: Reference
    target profile:
      v: http://hl7.org/fhir/StructureDefinition/Bundle
      l: Bundle
element:
  id:
    v: Extension.url
  path:
    v: Extension.url
  fixed: Uri
    v: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade
    l: ChangeMade
element:
  id:
    v: Extension.value[x]
  path:
    v: Extension.value[x]
  max:
    v: 0