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

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: ADI PMO Composition

This profile encompasses information that makes up a practitioner's portable medical order.

Usage:

• Refer to this Resource Profile: ADI PMO Participant Observation and ADI PMO Review Observation
• Examples for this Resource Profile: Composition/PMO-Example-Smith-Johnson-PMOComposition1

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from ADICompositionHeader

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) 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: 93037-0
author		1..*	Reference(US Core PractitionerRole Profile)	Who and/or what authored the composition
event
detail		0..*	Reference(ADI PMO ServiceRequest | ADI Participant Consent | ADI PMO Procedure)	The event(s) being documented
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:portable_medical_orders	S	1..1	BackboneElement	Portable Medical Orders
Slices for extension				Content/Rules for all slices
extension:ClauseExtension		0..*	ClauseExtension	Section clause, additional instructions, or information
title	S	1..1	string	Label for section (e.g. for ToC)
code	S	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: 59772-4
Slices for entry	S	0..*	Reference(ADI PMO ServiceRequest)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:cardiopulmonary_resuscitation_service_request	S	0..1	Reference(ADI PMO Cardiopulmonary Resuscitation ServiceRequest)	A reference to data that supports this section
entry:initial_treatment_service_request	S	0..1	Reference(ADI PMO Initial Treatment ServiceRequest)	A reference to data that supports this section
entry:additional_orders_or_instructions_service_request	S	0..*	Reference(ADI PMO Additional orders or instructions ServiceRequest)	A reference to data that supports this section
entry:medically_assisted_nutrition_service_request	S	0..1	Reference(ADI PMO Medically Assisted Nutrition Service Request)	A reference to data that supports this section
entry:medically_assisted_hydration_service_request	S	0..1	Reference(ADI PMO Medically Assisted Hydration Service Request)	A reference to data that supports this section
section:completion_information	S	0..1	BackboneElement	Portable medical order completion information
Slices for extension				Content/Rules for all slices
extension:ClauseExtension		0..*	ClauseExtension	Administrative, instructional, and/or legal information
title	S	1..1	string	Label for section (e.g. for ToC)
code	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ldo
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:orders_review		0..*	Reference(ADI PMO Review Observation)	A reference to data that supports this section
entry:orders_participant		0..*	Reference(ADI PMO Participant Observation)	A reference to data that supports this section
entry:hospice_observation		0..1	Reference(ADI PMO Hospice Observation)	A reference to data that supports this section
entry:hospice_agency		0..1	Reference(US Core Organization Profile)	A reference to data that supports this section
section:administration_information	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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: adm
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:adi_personal_goal	S	0..*	Reference(ADI PtAuthored 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	S	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	S	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 Participant)	A reference to data that supports this section
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
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 Bindings Purpose AllLanguages Max Binding
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
versionNumber	S	1..1	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
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
DocumentRevokeStatus	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)
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) 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: 93037-0
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 PractitionerRole 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:portable_medical_orders	SC	1..1	BackboneElement	Portable Medical Orders 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)	Section clause, additional instructions, or information 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	S	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: 59772-4
Slices for entry	SC	0..*	Reference(ADI PMO ServiceRequest)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:cardiopulmonary_resuscitation_service_request	SC	0..1	Reference(ADI PMO Cardiopulmonary Resuscitation ServiceRequest)	A reference to data that supports this section
entry:initial_treatment_service_request	SC	0..1	Reference(ADI PMO Initial Treatment ServiceRequest)	A reference to data that supports this section
entry:additional_orders_or_instructions_service_request	SC	0..*	Reference(ADI PMO Additional orders or instructions ServiceRequest)	A reference to data that supports this section
entry:medically_assisted_nutrition_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Nutrition Service Request)	A reference to data that supports this section
entry:medically_assisted_hydration_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Hydration Service Request)	A reference to data that supports this section
section:completion_information	SC	0..1	BackboneElement	Portable medical order completion 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)	Administrative, instructional, and/or legal information 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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ldo
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:orders_review	C	0..*	Reference(ADI PMO Review Observation)	A reference to data that supports this section
entry:orders_participant	C	0..*	Reference(ADI PMO Participant Observation)	A reference to data that supports this section
entry:hospice_observation	C	0..1	Reference(ADI PMO Hospice Observation)	A reference to data that supports this section
entry:hospice_agency	C	0..1	Reference(US Core Organization Profile)	A reference to data that supports this section
section:administration_information	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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: adm
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:adi_personal_goal	SC	0..*	Reference(ADI PtAuthored 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	S	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	S	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 Participant)	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	ADICompositionStatusVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG
Composition.type	extensible	Pattern: LOINC Code 93037-0 http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 from https://vsac.nlm.nih.gov
Composition.category	example	Pattern: LOINC Code 42348-3("Advance directives") http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.section:portable_medical_orders.code	example	Pattern: LOINC Code 59772-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:completion_information.code	example	Pattern: ldo http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:administration_information.code	example	Pattern: adm http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:additional_documentation.code	example	Pattern: LOINC Code 77599-9 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:witness_and_notary.code	example	Pattern: LOINC Code 81339-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
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
language	S	1..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
versionNumber	S	1..1	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
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
DocumentRevokeStatus	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)
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) 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: 93037-0
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
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 PractitionerRole 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(ADI PMO ServiceRequest | ADI Participant Consent | ADI PMO Procedure)	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:portable_medical_orders	SC	1..1	BackboneElement	Portable Medical Orders 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
ClauseExtension		0..*	(Complex)	Section clause, additional instructions, or information 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	S	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: 59772-4
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.
Slices for entry	SC	0..*	Reference(ADI PMO ServiceRequest)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:cardiopulmonary_resuscitation_service_request	SC	0..1	Reference(ADI PMO Cardiopulmonary Resuscitation ServiceRequest)	A reference to data that supports this section
entry:initial_treatment_service_request	SC	0..1	Reference(ADI PMO Initial Treatment ServiceRequest)	A reference to data that supports this section
entry:additional_orders_or_instructions_service_request	SC	0..*	Reference(ADI PMO Additional orders or instructions ServiceRequest)	A reference to data that supports this section
entry:medically_assisted_nutrition_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Nutrition Service Request)	A reference to data that supports this section
entry:medically_assisted_hydration_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Hydration Service Request)	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:completion_information	SC	0..1	BackboneElement	Portable medical order completion 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
ClauseExtension		0..*	(Complex)	Administrative, instructional, and/or legal information 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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ldo
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.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:orders_review	C	0..*	Reference(ADI PMO Review Observation)	A reference to data that supports this section
entry:orders_participant	C	0..*	Reference(ADI PMO Participant Observation)	A reference to data that supports this section
entry:hospice_observation	C	0..1	Reference(ADI PMO Hospice Observation)	A reference to data that supports this section
entry:hospice_agency	C	0..1	Reference(US Core Organization Profile)	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:administration_information	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
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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: adm
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.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:adi_personal_goal	SC	0..*	Reference(ADI PtAuthored 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
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	S	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
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	S	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 Participant)	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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	ADICompositionStatusVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG
Composition.type	extensible	Pattern: LOINC Code 93037-0 http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 from https://vsac.nlm.nih.gov
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	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:portable_medical_orders.code	example	Pattern: LOINC Code 59772-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:portable_medical_orders.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:portable_medical_orders.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:portable_medical_orders.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:completion_information.code	example	Pattern: ldo http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:completion_information.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:completion_information.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:completion_information.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:administration_information.code	example	Pattern: adm http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:administration_information.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:administration_information.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:administration_information.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:additional_documentation.code	example	Pattern: LOINC Code 77599-9 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:additional_documentation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:additional_documentation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:additional_documentation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:witness_and_notary.code	example	Pattern: LOINC Code 81339-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:witness_and_notary.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:witness_and_notary.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:witness_and_notary.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

This structure is derived from ADICompositionHeader

Summary

Mandatory: 5 elements(8 nested mandatory elements)
Must-Support: 23 elements

Structures

This structure refers to these other structures:

• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• ADI PMO ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOServiceRequest)
• ADI Participant Consent (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ParticipantConsent)
• ADI PMO Procedure (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOProcedure)
• ADI PMO Cardiopulmonary Resuscitation ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOCPRServiceRequest)
• ADI PMO Initial Treatment ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOInitialTreatmentServiceRequest)
• ADI PMO Additional orders or instructions ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOAdditionalOrdersOrInstructionsServiceRequest)
• ADI PMO Medically Assisted Nutrition Service Request (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOMedicallyAssistedNutritionServiceRequest)
• ADI PMO Medically Assisted Hydration Service Request (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOMedicallyAssistedHydrationServiceRequest)
• ADI PMO Review Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOReviewObservation)
• ADI PMO Participant Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOParticipantObservation)
• ADI PMO Hospice Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOHospiceObservation)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• ADI PtAuthored Personal Goal (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalGoal)
• ADI Documentation Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentationObservation)
• ADI Participant (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Participant)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Composition.section
• The element 1 is sliced based on the value of Composition.section.entry

Differential View

This structure is derived from ADICompositionHeader

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) 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: 93037-0
author		1..*	Reference(US Core PractitionerRole Profile)	Who and/or what authored the composition
event
detail		0..*	Reference(ADI PMO ServiceRequest | ADI Participant Consent | ADI PMO Procedure)	The event(s) being documented
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:portable_medical_orders	S	1..1	BackboneElement	Portable Medical Orders
Slices for extension				Content/Rules for all slices
extension:ClauseExtension		0..*	ClauseExtension	Section clause, additional instructions, or information
title	S	1..1	string	Label for section (e.g. for ToC)
code	S	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: 59772-4
Slices for entry	S	0..*	Reference(ADI PMO ServiceRequest)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:cardiopulmonary_resuscitation_service_request	S	0..1	Reference(ADI PMO Cardiopulmonary Resuscitation ServiceRequest)	A reference to data that supports this section
entry:initial_treatment_service_request	S	0..1	Reference(ADI PMO Initial Treatment ServiceRequest)	A reference to data that supports this section
entry:additional_orders_or_instructions_service_request	S	0..*	Reference(ADI PMO Additional orders or instructions ServiceRequest)	A reference to data that supports this section
entry:medically_assisted_nutrition_service_request	S	0..1	Reference(ADI PMO Medically Assisted Nutrition Service Request)	A reference to data that supports this section
entry:medically_assisted_hydration_service_request	S	0..1	Reference(ADI PMO Medically Assisted Hydration Service Request)	A reference to data that supports this section
section:completion_information	S	0..1	BackboneElement	Portable medical order completion information
Slices for extension				Content/Rules for all slices
extension:ClauseExtension		0..*	ClauseExtension	Administrative, instructional, and/or legal information
title	S	1..1	string	Label for section (e.g. for ToC)
code	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ldo
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:orders_review		0..*	Reference(ADI PMO Review Observation)	A reference to data that supports this section
entry:orders_participant		0..*	Reference(ADI PMO Participant Observation)	A reference to data that supports this section
entry:hospice_observation		0..1	Reference(ADI PMO Hospice Observation)	A reference to data that supports this section
entry:hospice_agency		0..1	Reference(US Core Organization Profile)	A reference to data that supports this section
section:administration_information	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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: adm
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:adi_personal_goal	S	0..*	Reference(ADI PtAuthored 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	S	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	S	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 Participant)	A reference to data that supports this section
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
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 Bindings Purpose AllLanguages Max Binding
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
versionNumber	S	1..1	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
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
DocumentRevokeStatus	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)
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) 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: 93037-0
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 PractitionerRole 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:portable_medical_orders	SC	1..1	BackboneElement	Portable Medical Orders 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)	Section clause, additional instructions, or information 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	S	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: 59772-4
Slices for entry	SC	0..*	Reference(ADI PMO ServiceRequest)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:cardiopulmonary_resuscitation_service_request	SC	0..1	Reference(ADI PMO Cardiopulmonary Resuscitation ServiceRequest)	A reference to data that supports this section
entry:initial_treatment_service_request	SC	0..1	Reference(ADI PMO Initial Treatment ServiceRequest)	A reference to data that supports this section
entry:additional_orders_or_instructions_service_request	SC	0..*	Reference(ADI PMO Additional orders or instructions ServiceRequest)	A reference to data that supports this section
entry:medically_assisted_nutrition_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Nutrition Service Request)	A reference to data that supports this section
entry:medically_assisted_hydration_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Hydration Service Request)	A reference to data that supports this section
section:completion_information	SC	0..1	BackboneElement	Portable medical order completion 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)	Administrative, instructional, and/or legal information 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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ldo
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:orders_review	C	0..*	Reference(ADI PMO Review Observation)	A reference to data that supports this section
entry:orders_participant	C	0..*	Reference(ADI PMO Participant Observation)	A reference to data that supports this section
entry:hospice_observation	C	0..1	Reference(ADI PMO Hospice Observation)	A reference to data that supports this section
entry:hospice_agency	C	0..1	Reference(US Core Organization Profile)	A reference to data that supports this section
section:administration_information	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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: adm
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:adi_personal_goal	SC	0..*	Reference(ADI PtAuthored 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	S	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	S	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 Participant)	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	ADICompositionStatusVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG
Composition.type	extensible	Pattern: LOINC Code 93037-0 http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 from https://vsac.nlm.nih.gov
Composition.category	example	Pattern: LOINC Code 42348-3("Advance directives") http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.section:portable_medical_orders.code	example	Pattern: LOINC Code 59772-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:completion_information.code	example	Pattern: ldo http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:administration_information.code	example	Pattern: adm http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:additional_documentation.code	example	Pattern: LOINC Code 77599-9 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:witness_and_notary.code	example	Pattern: LOINC Code 81339-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
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
language	S	1..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
versionNumber	S	1..1	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
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
DocumentRevokeStatus	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)
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) 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: 93037-0
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
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 PractitionerRole 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(ADI PMO ServiceRequest | ADI Participant Consent | ADI PMO Procedure)	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:portable_medical_orders	SC	1..1	BackboneElement	Portable Medical Orders 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
ClauseExtension		0..*	(Complex)	Section clause, additional instructions, or information 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	S	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: 59772-4
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.
Slices for entry	SC	0..*	Reference(ADI PMO ServiceRequest)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:cardiopulmonary_resuscitation_service_request	SC	0..1	Reference(ADI PMO Cardiopulmonary Resuscitation ServiceRequest)	A reference to data that supports this section
entry:initial_treatment_service_request	SC	0..1	Reference(ADI PMO Initial Treatment ServiceRequest)	A reference to data that supports this section
entry:additional_orders_or_instructions_service_request	SC	0..*	Reference(ADI PMO Additional orders or instructions ServiceRequest)	A reference to data that supports this section
entry:medically_assisted_nutrition_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Nutrition Service Request)	A reference to data that supports this section
entry:medically_assisted_hydration_service_request	SC	0..1	Reference(ADI PMO Medically Assisted Hydration Service Request)	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:completion_information	SC	0..1	BackboneElement	Portable medical order completion 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
ClauseExtension		0..*	(Complex)	Administrative, instructional, and/or legal information 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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ldo
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.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:orders_review	C	0..*	Reference(ADI PMO Review Observation)	A reference to data that supports this section
entry:orders_participant	C	0..*	Reference(ADI PMO Participant Observation)	A reference to data that supports this section
entry:hospice_observation	C	0..1	Reference(ADI PMO Hospice Observation)	A reference to data that supports this section
entry:hospice_agency	C	0..1	Reference(US Core Organization Profile)	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:administration_information	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
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	S	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://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: adm
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.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
entry:adi_personal_goal	SC	0..*	Reference(ADI PtAuthored 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
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	S	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
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	S	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 Participant)	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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	ADICompositionStatusVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADICompositionStatusVS from this IG
Composition.type	extensible	Pattern: LOINC Code 93037-0 http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4 from https://vsac.nlm.nih.gov
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	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:portable_medical_orders.code	example	Pattern: LOINC Code 59772-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:portable_medical_orders.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:portable_medical_orders.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:portable_medical_orders.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:completion_information.code	example	Pattern: ldo http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:completion_information.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:completion_information.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:completion_information.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:administration_information.code	example	Pattern: adm http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:administration_information.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:administration_information.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:administration_information.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:additional_documentation.code	example	Pattern: LOINC Code 77599-9 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:additional_documentation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:additional_documentation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:additional_documentation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:witness_and_notary.code	example	Pattern: LOINC Code 81339-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:witness_and_notary.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:witness_and_notary.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:witness_and_notary.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

This structure is derived from ADICompositionHeader

Summary

Mandatory: 5 elements(8 nested mandatory elements)
Must-Support: 23 elements

Structures

This structure refers to these other structures:

• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• ADI PMO ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOServiceRequest)
• ADI Participant Consent (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ParticipantConsent)
• ADI PMO Procedure (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOProcedure)
• ADI PMO Cardiopulmonary Resuscitation ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOCPRServiceRequest)
• ADI PMO Initial Treatment ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOInitialTreatmentServiceRequest)
• ADI PMO Additional orders or instructions ServiceRequest (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOAdditionalOrdersOrInstructionsServiceRequest)
• ADI PMO Medically Assisted Nutrition Service Request (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOMedicallyAssistedNutritionServiceRequest)
• ADI PMO Medically Assisted Hydration Service Request (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOMedicallyAssistedHydrationServiceRequest)
• ADI PMO Review Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOReviewObservation)
• ADI PMO Participant Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOParticipantObservation)
• ADI PMO Hospice Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOHospiceObservation)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• ADI PtAuthored Personal Goal (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalGoal)
• ADI Documentation Observation (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentationObservation)
• ADI Participant (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Participant)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Composition.section
• The element 1 is sliced based on the value of Composition.section.entry