PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions
Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Composition-Header | Version: 2.1.0 | |||
Active as of 2025-03-12 | Computable Name: ADICompositionHeader |
This abstract profile defines constraints that represent common administrative and demographic concepts for advance directives information used in US Realm clinical documents.
This profile, largely based on the CCDA on FHIR US Realm Header profile, defines requirements that address specific exchange requirements for a composition containing a person's advance care plan information.
Conformance:
In the cases where the patient is not able to "write" the PACP contents due to literacy constraints or physical disability, e.g. hemiplegia, the patient/subject is still considered author of the content, and a data enterer will fill the role of physically creating the document by entering the author’s requested information into the system used to create the document.
Advance Directive Information versionNumber represents a numeric value used to version successive replacement documents. Best practice for systems that support distributed document creation and updating is to populate the versionNumber with the timestamp created from the date/time when the version of the document is created in the system. Note: this may or may not be equivalent to the timestamp integer for Composition.date. the versionNumber timestamp always will be equivalent to the Bundle.timestamp for the document.
To better align with CDA, versionNumber should be a string label generated by converting the ClinicalDocument.effectiveTime (or Composition.date) to UTC time (-0000) and then using the YYYYMMDDhhmmss as the version.
For documents created within a system will follow the pattern that the timestamp-label versionNumber will be equivalent to the timestamp of the Composition.date and the Bundle.timestamp. However, for unstructured historical documents uploaded into a system, the timestamp-label versionNumber will be equivalent to the timestamp of the the Bundle.timestamp, but the Composition.date will reflect the creation date of the original document.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | Clinical Document | This is an abstract profile. Child profiles: ADIPACPComposition, ADIPMOComposition A set of resources composed into a single coherent clinical statement with clinical attestation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children | ||||
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S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
ele-1: All FHIR elements must have a @value or children | ||||
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1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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S | 1..1 | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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0..1 | Period | Effective Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction. ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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SΣ | 1..1 | Identifier | Version-independent identifier for the Composition ele-1: All FHIR elements must have a @value or children | ||||
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?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required) ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Directives Categories ![]() ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following | ||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
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1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3 | |||||
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1..1 | string | Representation defined by the system Fixed Value: Advance directives | |||||
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SΣ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about ele-1: All FHIR elements must have a @value or children | ||||
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Σ | 0..1 | Reference(US Core Encounter Profile) | Context of the Composition ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | dateTime | Composition editing time ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) | Who and/or what authored the composition ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | string | Human Readable name/title ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition ele-1: All FHIR elements must have a @value or children | ||||
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0..* | BackboneElement | Relationships to other compositions/documents ele-1: All FHIR elements must have a @value or children | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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S | 0..* | Reference(ADI Document Reference) | ADI Document Reference Extension URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-reference-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. ele-1: All FHIR elements must have a @value or children | |||||
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1..1 | Target of the relationship ele-1: All FHIR elements must have a @value or children | ||||||
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Identifier | |||||||
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Reference(Composition) | |||||||
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Path | Conformance | ValueSet / Code | URI | |||
Composition.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
Composition.status | required | ADICompositionStatusVShttp://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG | ||||
Composition.type | extensible | AdvanceDirectivesCategories ![]() http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 | ||||
Composition.category | example | Pattern: LOINC Code 42348-3("Advance directives")http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard | ||||
Composition.relatesTo.code | required | DocumentRelationshipTypehttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard |
This structure is derived from Clinical Document
Path | Conformance | ValueSet | URI |
Composition.status | required | ADICompositionStatusVShttp://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG | |
Composition.type | extensible | AdvanceDirectivesCategories ![]() http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 |
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
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0..* | Clinical Document | This is an abstract profile. Child profiles: ADIPACPComposition, ADIPMOComposition A set of resources composed into a single coherent clinical statement with clinical attestation | |||||
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Σ | 0..1 | id | Logical id of this artifact | ||||
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Σ | 0..1 | Meta | Metadata about the resource | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| ||||
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0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
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0..* | Resource | Contained, inline Resources | |||||
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1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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S | 1..1 | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber | ||||
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0..1 | Period | Effective Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension | |||||
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0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction. | |||||
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0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant-extension | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension | |||||
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0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension | |||||
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S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required) | ||||
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?! | 0..* | Extension | Extensions that cannot be ignored | ||||
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SΣ | 1..1 | Identifier | Version-independent identifier for the Composition | ||||
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?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required) | ||||
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SΣ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Directives Categories ![]() | ||||
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SΣ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
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0..1 | string | Version of the system - if relevant | |||||
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1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3 | |||||
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1..1 | string | Representation defined by the system Fixed Value: Advance directives | |||||
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0..1 | boolean | If this coding was chosen directly by the user | |||||
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0..1 | string | Plain text representation of the concept | |||||
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SΣ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about | ||||
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Σ | 0..1 | Reference(US Core Encounter Profile) | Context of the Composition | ||||
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SΣ | 1..1 | dateTime | Composition editing time | ||||
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SΣ | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) | Who and/or what authored the composition | ||||
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SΣ | 1..1 | string | Human Readable name/title | ||||
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0..* | BackboneElement | Attests to accuracy of composition | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. | |||||
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0..1 | dateTime | When the composition was attested | |||||
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0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) | Who attested the composition | |||||
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SΣ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition | ||||
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0..* | BackboneElement | Relationships to other compositions/documents | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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S | 0..* | Reference(ADI Document Reference) | ADI Document Reference Extension URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-reference-extension | ||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. | |||||
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1..1 | Target of the relationship | ||||||
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Identifier | |||||||
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Reference(Composition) | |||||||
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Σ | 0..* | BackboneElement | The clinical service(s) being documented | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Required Pattern: At least the following | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs | |||||
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0..1 | string | Version of the system - if relevant | |||||
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1..1 | code | Symbol in syntax defined by the system Fixed Value: acp-services | |||||
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1..1 | string | Representation defined by the system Fixed Value: Advance care planning services | |||||
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0..1 | boolean | If this coding was chosen directly by the user | |||||
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0..1 | string | Plain text representation of the concept | |||||
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Σ | 0..1 | Period | The period covered by the documentation | ||||
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Σ | 0..* | Reference(Resource) | The event(s) being documented Slice: Unordered, Open by profile:resolve() | ||||
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Σ | 0..1 | Reference(ADI Facilitator) | ADI Facilitator | ||||
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C | 0..* | BackboneElement | Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..1 | string | Label for section (e.g. for ToC) | |||||
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0..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. | |||||
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0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section | |||||
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0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition | |||||
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C | 0..1 | Narrative | Text summary of the section, for human interpretation | ||||
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0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section. | |||||
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0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry. | |||||
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C | 0..* | Reference(Resource) | A reference to data that supports this section | ||||
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C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty. | ||||
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C | 0..* | See section (Composition) | Nested Section | ||||
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Path | Conformance | ValueSet / Code | URI | |||
Composition.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
Composition.status | required | ADICompositionStatusVShttp://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG | ||||
Composition.type | extensible | AdvanceDirectivesCategories ![]() http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 | ||||
Composition.category | example | Pattern: LOINC Code 42348-3("Advance directives")http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard | ||||
Composition.attester.mode | required | CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard | ||||
Composition.relatesTo.code | required | DocumentRelationshipTypehttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard | ||||
Composition.event.code | example | Pattern: acp-services("Advance care planning services")http://terminology.hl7.org/ValueSet/v3-ActCode | ||||
Composition.section.code | example | DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard | ||||
Composition.section.mode | required | ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard | ||||
Composition.section.orderedBy | preferred | ListOrderCodeshttp://hl7.org/fhir/ValueSet/list-order from the FHIR Standard | ||||
Composition.section.emptyReason | preferred | ListEmptyReasonshttp://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard |
This structure is derived from Clinical Document
Summary
Mandatory: 6 elements
Must-Support: 12 elements
Prohibited: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Key Elements View
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | Clinical Document | This is an abstract profile. Child profiles: ADIPACPComposition, ADIPMOComposition A set of resources composed into a single coherent clinical statement with clinical attestation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children | ||||
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S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
ele-1: All FHIR elements must have a @value or children | ||||
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1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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S | 1..1 | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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0..1 | Period | Effective Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction. ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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SΣ | 1..1 | Identifier | Version-independent identifier for the Composition ele-1: All FHIR elements must have a @value or children | ||||
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?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required) ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Directives Categories ![]() ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following | ||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
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1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3 | |||||
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1..1 | string | Representation defined by the system Fixed Value: Advance directives | |||||
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SΣ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about ele-1: All FHIR elements must have a @value or children | ||||
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Σ | 0..1 | Reference(US Core Encounter Profile) | Context of the Composition ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | dateTime | Composition editing time ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) | Who and/or what authored the composition ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | string | Human Readable name/title ele-1: All FHIR elements must have a @value or children | ||||
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SΣ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition ele-1: All FHIR elements must have a @value or children | ||||
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0..* | BackboneElement | Relationships to other compositions/documents ele-1: All FHIR elements must have a @value or children | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
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S | 0..* | Reference(ADI Document Reference) | ADI Document Reference Extension URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-reference-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
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1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. ele-1: All FHIR elements must have a @value or children | |||||
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1..1 | Target of the relationship ele-1: All FHIR elements must have a @value or children | ||||||
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Identifier | |||||||
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Reference(Composition) | |||||||
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Path | Conformance | ValueSet / Code | URI | |||
Composition.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
Composition.status | required | ADICompositionStatusVShttp://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG | ||||
Composition.type | extensible | AdvanceDirectivesCategories ![]() http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 | ||||
Composition.category | example | Pattern: LOINC Code 42348-3("Advance directives")http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard | ||||
Composition.relatesTo.code | required | DocumentRelationshipTypehttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard |
Differential View
This structure is derived from Clinical Document
Path | Conformance | ValueSet | URI |
Composition.status | required | ADICompositionStatusVShttp://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG | |
Composition.type | extensible | AdvanceDirectivesCategories ![]() http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | Clinical Document | This is an abstract profile. Child profiles: ADIPACPComposition, ADIPMOComposition A set of resources composed into a single coherent clinical statement with clinical attestation | |||||
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Σ | 0..1 | id | Logical id of this artifact | ||||
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Σ | 0..1 | Meta | Metadata about the resource | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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S | 1..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| ||||
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0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
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0..* | Resource | Contained, inline Resources | |||||
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1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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S | 1..1 | string | Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber | ||||
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0..1 | Period | Effective Date URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension | |||||
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0..* | CodeableConcept | US State or local jurisdiction URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction Binding: USPS Two Letter Alphabetic Codes (extensible): Target US State or local jurisdiction. | |||||
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0..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Data Enterer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Informant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) | Participant URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant-extension | |||||
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0..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Performer URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension | |||||
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0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension | |||||
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S | 0..1 | code | Revoke Status URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status Binding: ADI Document Revoke Status (required) | ||||
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?! | 0..* | Extension | Extensions that cannot be ignored | ||||
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SΣ | 1..1 | Identifier | Version-independent identifier for the Composition | ||||
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?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: ADI Composition Status (required) | ||||
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SΣ | 1..1 | CodeableConcept | Kind of composition (LOINC if possible) Binding: Advance Directives Categories ![]() | ||||
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SΣ | 0..1 | CodeableConcept | Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
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0..1 | string | Version of the system - if relevant | |||||
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1..1 | code | Symbol in syntax defined by the system Fixed Value: 42348-3 | |||||
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1..1 | string | Representation defined by the system Fixed Value: Advance directives | |||||
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0..1 | boolean | If this coding was chosen directly by the user | |||||
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0..1 | string | Plain text representation of the concept | |||||
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SΣ | 1..1 | Reference(US Core Patient Profile) | Who and/or what the composition is about | ||||
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Σ | 0..1 | Reference(US Core Encounter Profile) | Context of the Composition | ||||
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SΣ | 1..1 | dateTime | Composition editing time | ||||
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SΣ | 1..* | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson) | Who and/or what authored the composition | ||||
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SΣ | 1..1 | string | Human Readable name/title | ||||
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0..* | BackboneElement | Attests to accuracy of composition | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. | |||||
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0..1 | dateTime | When the composition was attested | |||||
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0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) | Who attested the composition | |||||
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SΣ | 1..1 | Reference(US Core Organization Profile) | Organization which maintains the composition | ||||
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0..* | BackboneElement | Relationships to other compositions/documents | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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S | 0..* | Reference(ADI Document Reference) | ADI Document Reference Extension URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-reference-extension | ||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. | |||||
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1..1 | Target of the relationship | ||||||
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Identifier | |||||||
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Reference(Composition) | |||||||
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Σ | 0..* | BackboneElement | The clinical service(s) being documented | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Required Pattern: At least the following | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs | |||||
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0..1 | string | Version of the system - if relevant | |||||
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1..1 | code | Symbol in syntax defined by the system Fixed Value: acp-services | |||||
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1..1 | string | Representation defined by the system Fixed Value: Advance care planning services | |||||
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0..1 | boolean | If this coding was chosen directly by the user | |||||
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0..1 | string | Plain text representation of the concept | |||||
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Σ | 0..1 | Period | The period covered by the documentation | ||||
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Σ | 0..* | Reference(Resource) | The event(s) being documented Slice: Unordered, Open by profile:resolve() | ||||
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Σ | 0..1 | Reference(ADI Facilitator) | ADI Facilitator | ||||
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C | 0..* | BackboneElement | Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..1 | string | Label for section (e.g. for ToC) | |||||
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0..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. | |||||
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0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section | |||||
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0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition | |||||
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C | 0..1 | Narrative | Text summary of the section, for human interpretation | ||||
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0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section. | |||||
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0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry. | |||||
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C | 0..* | Reference(Resource) | A reference to data that supports this section | ||||
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C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty. | ||||
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C | 0..* | See section (Composition) | Nested Section | ||||
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Path | Conformance | ValueSet / Code | URI | |||
Composition.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
Composition.status | required | ADICompositionStatusVShttp://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG | ||||
Composition.type | extensible | AdvanceDirectivesCategories ![]() http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 | ||||
Composition.category | example | Pattern: LOINC Code 42348-3("Advance directives")http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard | ||||
Composition.attester.mode | required | CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard | ||||
Composition.relatesTo.code | required | DocumentRelationshipTypehttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard | ||||
Composition.event.code | example | Pattern: acp-services("Advance care planning services")http://terminology.hl7.org/ValueSet/v3-ActCode | ||||
Composition.section.code | example | DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard | ||||
Composition.section.mode | required | ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard | ||||
Composition.section.orderedBy | preferred | ListOrderCodeshttp://hl7.org/fhir/ValueSet/list-order from the FHIR Standard | ||||
Composition.section.emptyReason | preferred | ListEmptyReasonshttp://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard |
This structure is derived from Clinical Document
Summary
Mandatory: 6 elements
Must-Support: 12 elements
Prohibited: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron