PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2 United States of America flag

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

Resource Profile: ADI Personal Advance Care Plan Composition

Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PACPComposition Version: 2.1.0
Active as of 2024-07-17 Computable Name: ADIPACPComposition

This profile encompasses information that makes up the author’s advance care information plan.

This profile defines the requirements for communicating a Personal Advance Care Plan (PACP) using a Composition Resource. It is used to create a person-generated document which is authored by the subject of the document (the patient). It contains information about the person’s goals, preferences, and priorities (GPPs) for care and treatment under certain future conditions.

It is possible for a PACP composition to only contain textual information and not have any encoded entries. In this case, an implementer may populate the section.text element in place of a resource reference in the section.entry element.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from ADICompositionHeader

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition C 0..* ADICompositionHeader A set of resources composed into a single coherent clinical statement with clinical attestation
HCA-section-cardinality: If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)
HCA-section-emptyReason-required: section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.
... author 1..* Reference(US Core Patient Profile) Who and/or what authored the composition
... Slices for section 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
.... section:All Slices Content/Rules for all slices
..... text S 1..1 Narrative Text summary of the section, for human interpretation
.... section:healthcare_agent C 0..1 BackboneElement Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations
HCA-section-entries: If healthcare agent section entry exists, then the HCA consent entry and HCA relatedPerson entry must exist
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81335-2
..... entry 0..* Reference(ADI Participant Consent | ADI Participant) A reference to data that supports this section
..... emptyReason 0..1 CodeableConcept This is only MS (must support) if the document types are supported.
Binding: No Healthcare Agent Included Reason (required)
.... section:gpp_for_certain_health_condition S 0..1 BackboneElement Preference care plans defined for specific situations and/or conditions
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81336-0
..... entry 0..* Reference(ADI Preference Care Plan) A reference to data that supports this section
.... section:gpp_personal_care_experience S 0..1 BackboneElement Quality of Life related personal care experiences, personal goals, and priorities
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81338-6
..... entry 0..* Reference(ADI Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) A reference to data that supports this section
.... section:gpp_upon_death S 0..1 BackboneElement Goals, preferences, and priorities upon death
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81337-8
..... entry 0..* Reference(ADI Preference Care Plan | Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal) A reference to data that supports this section
.... section:additional_documentation S 0..1 BackboneElement Observations regarding the existence of other advance directive related information
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 77599-9
..... entry 0..* Reference(ADI Documentation Observation) A reference to data that supports this section
.... section:witness_and_notary S 0..1 BackboneElement Witness and notary information. The first witness should be the author of the document
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81339-4
..... entry 0..* Reference(ADI Witness | ADI Notary) A reference to data that supports this section
.... section:administrative_information S 0..1 BackboneElement Administrative information associated with this personal advance care plan
..... Slices for extension Content/Rules for all slices
...... extension:ClauseExtension 0..* ClauseExtension Clause
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81381-6

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Composition.section:healthcare_agent.emptyReasonrequiredADINoHealthcareAgentIncludedReasonVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS
from this IG

Constraints

IdGradePath(s)DetailsRequirements
HCA-section-cardinalityerrorCompositionIf the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)
: (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1
HCA-section-emptyReason-requirederrorCompositionsection[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.
: section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists()
HCA-section-entrieserrorComposition.section:healthcare_agentIf healthcare agent section entry exists, then the HCA consent entry and HCA relatedPerson entry must exist
: entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is relatedPerson).exists())
NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition C 0..* ADICompositionHeader A set of resources composed into a single coherent clinical statement with clinical attestation
HCA-section-cardinality: If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)
HCA-section-emptyReason-required: section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language S 1..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... Slices for extension Content/Rules for all slices
.... versionNumber 0..* string Version-specific identifier for composition
URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
.... VersionNumber S 0..1 integer Version Number
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-versionNumber-extension
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 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
.... InformantExtension 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
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatusExtension S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status-extension
Binding: ADI Document Revoke Status (required)
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
... status ?!Σ 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category 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
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... date SΣ 1..1 dateTime Composition editing time
... author SΣ 1..* Reference(US Core Patient Profile) Who and/or what authored the composition
... title SΣ 1..1 string Human Readable name/title
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... Slices for section C 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
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
.... section:All Slices Content/Rules for all slices
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... text SC 1..1 Narrative Text summary of the section, for human interpretation
.... section:healthcare_agent C 0..1 BackboneElement Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations
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
HCA-section-entries: If healthcare agent section entry exists, then the HCA consent entry and HCA relatedPerson entry must exist
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81335-2
..... entry C 0..* Reference(ADI Participant Consent | ADI Participant) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept This is only MS (must support) if the document types are supported.
Binding: No Healthcare Agent Included Reason (required)
.... section:gpp_for_certain_health_condition SC 0..1 BackboneElement Preference care plans defined for specific situations and/or conditions
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
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81336-0
..... entry C 0..* Reference(ADI Preference Care Plan) A reference to data that supports this section
.... section:gpp_personal_care_experience SC 0..1 BackboneElement Quality of Life related personal care experiences, personal goals, and priorities
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
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81338-6
..... entry C 0..* Reference(ADI Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) A reference to data that supports this section
.... section:gpp_upon_death SC 0..1 BackboneElement Goals, preferences, and priorities upon death
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
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81337-8
..... entry C 0..* Reference(ADI Preference Care Plan | Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal) A reference to data that supports this section
.... section:additional_documentation SC 0..1 BackboneElement Observations regarding the existence of other advance directive related information
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
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 77599-9
..... entry C 0..* Reference(ADI Documentation Observation) A reference to data that supports this section
.... section:witness_and_notary SC 0..1 BackboneElement Witness and notary information. The first witness should be the author of the document
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
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81339-4
..... entry C 0..* Reference(ADI Witness | ADI Notary) A reference to data that supports this section
.... section:administrative_information SC 0..1 BackboneElement Administrative information associated with this personal advance care plan
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
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81381-6

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
Composition.categoryexamplePattern: LOINC Code 42348-3("Advance directives")
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
Composition.section:healthcare_agent.codeexamplePattern: LOINC Code 81335-2
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:healthcare_agent.emptyReasonrequiredADINoHealthcareAgentIncludedReasonVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS
from this IG
Composition.section:gpp_for_certain_health_condition.codeexamplePattern: LOINC Code 81336-0
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:gpp_personal_care_experience.codeexamplePattern: LOINC Code 81338-6
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:gpp_upon_death.codeexamplePattern: LOINC Code 81337-8
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:additional_documentation.codeexamplePattern: LOINC Code 77599-9
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:witness_and_notary.codeexamplePattern: LOINC Code 81339-4
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:administrative_information.codeexamplePattern: LOINC Code 81381-6
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
HCA-section-cardinalityerrorCompositionIf the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)
: (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1
HCA-section-emptyReason-requirederrorCompositionsection[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.
: section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists()
HCA-section-entrieserrorComposition.section:healthcare_agentIf healthcare agent section entry exists, then the HCA consent entry and HCA relatedPerson entry must exist
: entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is relatedPerson).exists())
NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition C 0..* ADICompositionHeader A set of resources composed into a single coherent clinical statement with clinical attestation
HCA-section-cardinality: If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)
HCA-section-emptyReason-required: section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... versionNumber 0..* string Version-specific identifier for composition
URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
.... VersionNumber S 0..1 integer Version Number
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-versionNumber-extension
.... EffectiveDateExtension 0..1 Period Effective Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension
.... Jurisdiction 0..* CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: Jurisdiction ValueSet (extensible)
.... DataEntererExtension 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
.... InformantExtension 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
.... ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-participant-extension
.... PerformerExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) Performer
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension
.... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
.... DocumentRevokeStatusExtension S 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status-extension
Binding: ADI Document Revoke Status (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
... status ?!Σ 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)
... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directives Categories . (extensible)
... category 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
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 42348-3
..... display 1..1 string Representation defined by the system
Fixed Value: Advance directives
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about
... encounter Σ 0..1 Reference(US Core Encounter Profile) Context of the Composition
... date SΣ 1..1 dateTime Composition editing time
... author SΣ 1..* Reference(US Core Patient Profile) Who and/or what authored the composition
... title SΣ 1..1 string Human Readable name/title
... attester 0..* BackboneElement Attests to accuracy of composition
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... mode 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.

.... time 0..1 dateTime When the composition was attested
.... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
... custodian SΣ 1..1 Reference(US Core Organization Profile) Organization which maintains the composition
... relatesTo 0..* BackboneElement Relationships to other compositions/documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target[x] 1..1 Target of the relationship
..... targetIdentifier Identifier
..... targetReference Reference(Composition)
... event Σ 0..* BackboneElement The clinical service(s) being documented
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 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.


.... period Σ 0..1 Period The period covered by the documentation
.... detail Σ 0..* Reference(Resource) The event(s) being documented
... Slices for section C 1..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
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
.... section:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title 0..1 string Label for section (e.g. for ToC)
..... code 0..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.

..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text SC 1..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(Resource) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section
.... section:healthcare_agent C 0..1 BackboneElement Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations
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
HCA-section-entries: If healthcare agent section entry exists, then the HCA consent entry and HCA relatedPerson entry must exist
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81335-2
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(ADI Participant Consent | ADI Participant) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept This is only MS (must support) if the document types are supported.
Binding: No Healthcare Agent Included Reason (required)
..... section C 0..* See section (Composition) Nested Section
.... section:gpp_for_certain_health_condition SC 0..1 BackboneElement Preference care plans defined for specific situations and/or conditions
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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81336-0
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(ADI Preference Care Plan) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section
.... section:gpp_personal_care_experience SC 0..1 BackboneElement Quality of Life related personal care experiences, personal goals, and priorities
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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81338-6
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(ADI Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section
.... section:gpp_upon_death SC 0..1 BackboneElement Goals, preferences, and priorities upon death
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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81337-8
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(ADI Preference Care Plan | Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation | ADI Personal Goal) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section
.... section:additional_documentation SC 0..1 BackboneElement Observations regarding the existence of other advance directive related information
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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 77599-9
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(ADI Documentation Observation) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section
.... section:witness_and_notary SC 0..1 BackboneElement Witness and notary information. The first witness should be the author of the document
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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81339-4
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(ADI Witness | ADI Notary) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section
.... section:administrative_information SC 0..1 BackboneElement Administrative information associated with this personal advance care plan
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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... title S 1..1 string Label for section (e.g. for ToC)
..... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 81381-6
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
..... focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition
..... text C 0..1 Narrative Text summary of the section, for human interpretation
..... mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

..... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

..... entry C 0..* Reference(Resource) A reference to data that supports this section
..... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

..... section C 0..* See section (Composition) Nested Section

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Composition.statusrequiredADICompositionStatusVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS
from this IG
Composition.typeextensibleAdvanceDirectivesCategories .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4
Composition.categoryexamplePattern: LOINC Code 42348-3("Advance directives")
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
Composition.attester.moderequiredCompositionAttestationMode
http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
from the FHIR Standard
Composition.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
Composition.event.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.codeexampleDocumentSectionCodes
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard
Composition.section:healthcare_agent.codeexamplePattern: LOINC Code 81335-2
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:healthcare_agent.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:healthcare_agent.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:healthcare_agent.emptyReasonrequiredADINoHealthcareAgentIncludedReasonVS
http://hl7.org/fhir/us/pacio-adi/ValueSet/ADINoHealthcareAgentIncludedReasonVS
from this IG
Composition.section:gpp_for_certain_health_condition.codeexamplePattern: LOINC Code 81336-0
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:gpp_for_certain_health_condition.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:gpp_for_certain_health_condition.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:gpp_for_certain_health_condition.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard
Composition.section:gpp_personal_care_experience.codeexamplePattern: LOINC Code 81338-6
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:gpp_personal_care_experience.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:gpp_personal_care_experience.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:gpp_personal_care_experience.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard
Composition.section:gpp_upon_death.codeexamplePattern: LOINC Code 81337-8
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:gpp_upon_death.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:gpp_upon_death.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:gpp_upon_death.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard
Composition.section:additional_documentation.codeexamplePattern: LOINC Code 77599-9
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:additional_documentation.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:additional_documentation.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:additional_documentation.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard
Composition.section:witness_and_notary.codeexamplePattern: LOINC Code 81339-4
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:witness_and_notary.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:witness_and_notary.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:witness_and_notary.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard
Composition.section:administrative_information.codeexamplePattern: LOINC Code 81381-6
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section:administrative_information.moderequiredListMode
http://hl7.org/fhir/ValueSet/list-mode|4.0.1
from the FHIR Standard
Composition.section:administrative_information.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section:administrative_information.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
HCA-section-cardinalityerrorCompositionIf the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)
: (type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1
HCA-section-emptyReason-requirederrorCompositionsection[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.
: section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists()
HCA-section-entrieserrorComposition.section:healthcare_agentIf healthcare agent section entry exists, then the HCA consent entry and HCA relatedPerson entry must exist
: entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is relatedPerson).exists())