ADI Person-Authored Composition - PACIO Advance Healthcare Directive Interoperability Implementation Guide v2.0.0

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

Resource Profile: ADI Person-Authored Composition

Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PACPComposition				Version: 2.0.0
Standards status: Trial-use				Computable Name: ADIPACPComposition
Other Identifiers: OID:2.16.840.1.113883.4.642.40.68.42.16

This Composition profile is used to represent a Person-Authored advance healthcare directive document. A Person-Authored advance healthcare directive document is categorized as a personal advance care plan (Personal ACP) document. This subset of advance healthcare directive documents expresses the person’s own preferences and consent to appoint a healthcare agent(s) and permit or deny the healthcare agent’s powers to make decisions when the person can’t communicate.

The Personal ACP subset of advance healthcare directive documents is always authored by the subject of the document (the person or patient). If care team members are involved in the creation of advance healthcare directive types of documents, they may be included as “facilitators” or contributors to the process, but they may or may not be signers of the resultant document. The person (or their representative) is required to sign the Personal ACP document and is represented as personal attester. Others who sign the document are represented as attesters, with their role of witness (official) or notary (professional). The Personal ACP Composition which is being exchanged or made accessible includes a representation of the completed source form. The Composition can also include information about:

The person’s appointed healthcare agent(s),
Treatment intervention and care experience preferences, with the ability to further specify those preferences under potential, future health scenarios
Administrative information; Completion information; Additional Documentation; and Upon death preferences; and
Witness and notary information (if that information is required for the specific form being represented to be considered valid.)

An advance healthcare directive document must always contain the source form representation in the Source Form section. It may include other textual information organized in standard structural sections, which may or may not include machine processable encoded entries.

Usages:

Use this Profile: ADI Bundle
Examples for this Profile: Composition/Example-Smith-Johnson-PACPComposition1 and Composition/MHAD-Example-Smith-Johnson-Composition
CapabilityStatements using this Profile: ADI CapabilityStatement

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
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Description & Constraints Filter:

Composition C 0..* ADICompositionHeader A set of resources composed into a single coherent clinical statement with clinical attestation
Constraints: clindoc-limit-participantType, HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type

Composition.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created

language

1..1

code

Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional Bindings

Purpose

AllLanguages

Max Binding

Composition.text This element must be supported. 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for extension Content/Rules for all slices

Composition.Slices for extension.extension:R5-Composition-version 0..1 string R5: An explicitly assigned identifer of a variation of the content in the Composition (new)
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version
Constraints: ext-1

Composition.Slices for extension.extension:data-enterer 0..1 (Complex) A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension

Composition.Slices for extension.extension:informant 0..* (Complex) An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension

Composition.Slices for extension.extension:information-recipient 0..* (Complex) An Information Recipient is the intended recipient of the information at the time the document was created.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension

Composition.Slices for extension.extension:participant This element must be supported. 0..* (Complex) A Participant that is not a data-enter, information-recipient nor an informant
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension

Composition.Slices for extension.extension:consent 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension

Composition.Slices for extension.extension:basedOn 0..* Reference(Resource) The clinical action, such as a plan, proposal or order that is fulfilled by or precipitated this FHIR Clinical Document, such as a radiologists report of an x-ray.
URL: http://hl7.org/fhir/StructureDefinition/event-basedOn

Composition.Slices for extension.extension:change-made 0..1 (Complex) Note of changes made, calculating changes maybe required for safety as this extension may not contain all changes. Experimental, may overlap with other elements such as FHIR R6 note.
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for extension.extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension

Composition.Slices for extension.extension: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

Composition.Slices for extension.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

Composition.Slices for extension.extension:ParticipantExtension 0..* Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | RelatedPerson) Participant
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension

Composition.Slices for extension.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

Composition.Slices for extension.extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Composition.Slices for extension.extension:DocumentRevokeStatus This element must be supported. 0..1 code Revoke Status
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status
Binding: ADI Document Revoke Status (required)

Composition.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored

Composition.identifier This element must be supported. This element is included in summaries. 1..1 Identifier Version-independent identifier for the Composition

Composition.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code preliminary | final | amended | entered-in-error
Binding: ADI Composition Status (required)

Composition.status.Slices for extension Content/Rules for all slices

Composition.status.Slices for extension.extension:R5-Composition-status 0..1 code This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status
Binding: R5CompositionStatusForR4 (0.1.0) (required): The workflow/clinical status of the composition.
Constraints: ext-1

Composition.type This element must be supported. This element is included in summaries. 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: Advance Directive Document Types (extensible)

Composition.Slices for category This element is included in summaries. 1..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by value:$this
Binding: Advance Healthcare Directive Categories LOINC (extensible)

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

category:clinicalnotecategory

0..1

CodeableConcept

Category for Clinical Note
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107903-7",
      "display" : "Clinical note"
    }
  ]
}

category:advanceDirectiveCategory

1..1

CodeableConcept

Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC

(extensible)

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "42348-3",
      "display" : "Advance healthcare directives"
    }
  ]
}

Composition.subject This element must be supported. This element is included in summaries. 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about

Composition.date This element must be supported. This element is included in summaries. 1..1 dateTime Composition editing time

Composition.author This element must be supported. This element is included in summaries. 1..* Reference(US Core Patient Profile) Who and/or what authored the composition

Composition.title This element must be supported. This element is included in summaries. 1..1 string Human Readable name/title

Composition.Slices for attester This element must be supported. 1..* BackboneElement Attests to accuracy of composition
Slice: Unordered, Open by value:mode

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Composition.Slices for attester.attester:All Slices Content/Rules for all slices

Composition.Slices for attester.attester:All Slices.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for attester.attester:All Slices.mode 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
Required Pattern: personal (extensions allowed)

Composition.Slices for attester.attester:All Slices.party 0..1 Reference(US Core Patient Profile | RelatedPerson | ADI Witness | ADI Notary | ADI Practitioner Role) Who attested the composition

Composition.Slices for attester.attester:legal_attester 0..1 BackboneElement aka legal authenticator

Composition.Slices for attester.attester:legal_attester.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for attester.attester:legal_attester.mode 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
Required Pattern: legal (extensions allowed)

Composition.Slices for attester.attester:legal_attester.party 0..1 Reference(US Core Patient Profile | RelatedPerson | ADI Witness | ADI Notary | ADI Practitioner Role) Who attested the composition

Composition.Slices for attester.attester:professional_attester 0..* BackboneElement aka authenticator

Composition.Slices for attester.attester:professional_attester.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for attester.attester:professional_attester.mode 1..1 code personal | professional | legal | official
Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
Required Pattern: professional (extensions allowed)

Composition.Slices for attester.attester:professional_attester.party 0..1 Reference(US Core Patient Profile | RelatedPerson | ADI Witness | ADI Notary | ADI Practitioner Role) Who attested the composition

Composition.custodian This element must be supported. This element is included in summaries. 1..1 Reference(US Core Organization Profile) Organization which maintains the composition

Composition.Slices for relatesTo 0..* BackboneElement Relationships to other compositions/documents
Slice: Unordered, Open by value:code, type:target

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Composition.Slices for relatesTo.relatesTo:All Slices Content/Rules for all slices

Composition.Slices for relatesTo.relatesTo:All Slices.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for relatesTo.relatesTo:All Slices.code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x] 1..1 Target of the relationship
Slice: Unordered, Open by type:$this

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x].targetIdentifier Identifier

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x].targetReference Reference(Composition)

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x].target[x]:targetIdentifier 0..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document

Composition.Slices for relatesTo.relatesTo:replaced_document 0..* BackboneElement The document(s) being superceded

Composition.Slices for relatesTo.relatesTo:replaced_document.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for relatesTo.relatesTo:replaced_document.code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
Required Pattern: replaces (extensions allowed)

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x] Content/Rules for all slices

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier 1..1 Identifier Reference to the Bundle.identifier of the FHIR Clinical Document being replaced, or to some other identifier of a non FHIR document

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.system This element is included in summaries. 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456

Composition.Slices for relatesTo.relatesTo:appended_document 0..* BackboneElement The document(s) being appended too

Composition.Slices for relatesTo.relatesTo:appended_document.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for relatesTo.relatesTo:appended_document.code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
Required Pattern: appends (extensions allowed)

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x] Content/Rules for all slices

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier 1..1 Identifier Target of the relationship

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.use This element is a modifier element. This element is included in summaries. 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

Composition.Slices for section This element must be supported. C 2..* BackboneElement Composition is broken into sections
Slice: Unordered, Open by pattern:code
Constraints: cmp-1, cmp-2

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Composition.Slices for section.section:All Slices Content/Rules for all slices

Composition.Slices for section.section:All Slices.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:All Slices.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:All Slices.Slices for extension.extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Composition.Slices for section.section:All Slices.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:All Slices.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

Composition.Slices for section.section:All Slices.code This element must be supported. 0..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.

Composition.Slices for section.section:All Slices.text This element must be supported. C 1..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:advance_directive_source_form This element must be supported. C 1..1 BackboneElement Advance directive source form
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:advance_directive_source_form.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:advance_directive_source_form.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:advance_directive_source_form.Slices for extension.extension:ADISourceFormJurisdiction This element must be supported. 0..1 CodeableConcept Jurisdiction
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension
Binding: UspsTwoLetterAlphabeticCodes (2.0.0) (extensible)

Composition.Slices for section.section:advance_directive_source_form.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:advance_directive_source_form.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs",
      "code" : "advance_directive_source_form"
    }
  ]
}

Composition.Slices for section.section:advance_directive_source_form.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:healthcare_agent This element must be supported. C 1..1 BackboneElement Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations
Constraints: cmp-1, cmp-2, HCA-section-entries

Composition.Slices for section.section:healthcare_agent.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:healthcare_agent.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:healthcare_agent.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:healthcare_agent.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81335-2"
    }
  ]
}

Composition.Slices for section.section:healthcare_agent.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:healthcare_agent.entry C 0..* Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) A reference to data that supports this section

Composition.Slices for section.section:healthcare_agent.emptyReason C 0..1 CodeableConcept This is only MS (must support) if the document types are supported.
Binding: No Healthcare Agent Included Reason (required)

Composition.Slices for section.section:gpp_for_certain_health_condition This element must be supported. C 0..1 BackboneElement Preference care plans defined for specific situations and/or conditions
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:gpp_for_certain_health_condition.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:gpp_for_certain_health_condition.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:gpp_for_certain_health_condition.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:gpp_for_certain_health_condition.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107905-2"
    }
  ]
}

Composition.Slices for section.section:gpp_for_certain_health_condition.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:gpp_for_certain_health_condition.entry C 0..* Reference(ADI Person-Authored Preference Care Plan | ADI Person Authored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Personal Goal) A reference to data that supports this section

Composition.Slices for section.section:gpp_personal_care_experience This element must be supported. C 0..1 BackboneElement Quality of Life related personal care experiences, personal goals, and priorities
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:gpp_personal_care_experience.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:gpp_personal_care_experience.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:gpp_personal_care_experience.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:gpp_personal_care_experience.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81338-6"
    }
  ]
}

Composition.Slices for section.section:gpp_personal_care_experience.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:gpp_personal_care_experience.entry C 0..* Reference(ADI Person-Authored Care Experience Preference | ADI Personal Priorities Organizer | ADI Personal Goal) A reference to data that supports this section

Composition.Slices for section.section:gpp_upon_death This element must be supported. C 0..1 BackboneElement Goals, preferences, and priorities upon death
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:gpp_upon_death.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:gpp_upon_death.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:gpp_upon_death.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:gpp_upon_death.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81337-8"
    }
  ]
}

Composition.Slices for section.section:gpp_upon_death.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:gpp_upon_death.entry C 0..* Reference(ADI Person Authored Personal Intervention Preference | ADI Personal Priorities Organizer | ADI Autopsy Observation | ADI Organ Donation Observation | ADI Personal Goal | ADI Upon Death Preferences) A reference to data that supports this section

Composition.Slices for section.section:additional_documentation This element must be supported. C 0..1 BackboneElement Observations regarding the existence of other advance directive related information
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:additional_documentation.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:additional_documentation.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:additional_documentation.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:additional_documentation.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "77599-9"
    }
  ]
}

Composition.Slices for section.section:additional_documentation.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:additional_documentation.entry C 0..* Reference(US Core Observation ADI Documentation Profile) A reference to data that supports this section

Composition.Slices for section.section:witness_and_notary This element must be supported. C 0..1 BackboneElement Witness and notary information. The first witness should be the author of the document
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:witness_and_notary.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:witness_and_notary.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:witness_and_notary.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:witness_and_notary.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81339-4"
    }
  ]
}

Composition.Slices for section.section:witness_and_notary.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Composition.Slices for section.section:witness_and_notary.entry C 0..* Reference(ADI Witness | ADI Notary) A reference to data that supports this section

Composition.Slices for section.section:administrative_information This element must be supported. C 0..1 BackboneElement Administrative information associated with this personal advance care plan
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:administrative_information.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:administrative_information.Slices for extension.extension:change-made 0..1 (Complex) Change Made
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade

Composition.Slices for section.section:administrative_information.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

Composition.Slices for section.section:administrative_information.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107904-5"
    }
  ]
}

Composition.Slices for section.section:administrative_information.text This element must be supported. C 0..1 Narrative Text summary of the section, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements

Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Composition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Composition.status	Base	required	ADI Composition Status	📦2.0.0	This IG
Composition.type	Base	extensible	Advance Directive Document Types	⏿20240712	tx.fhir.org
Composition.category	Base	extensible	Advance Healthcare Directive Categories LOINC	⏿20260912	tx.fhir.org
Composition.category:clinicalnotecategory	Base	example	Document Class Value Set	📍4.0.1	FHIR Std.
Composition.category:advanceDirectiveCategory	Base	extensible	Advance Healthcare Directive Categories LOINC	⏿20260912	tx.fhir.org
Composition.attester.mode	Base	required	CompositionAttestationMode	📍4.0.1	FHIR Std.
Composition.attester:legal_attester.mode	Base	required	CompositionAttestationMode	📍4.0.1	FHIR Std.
Composition.attester:professional_attester.mode	Base	required	CompositionAttestationMode	📍4.0.1	FHIR Std.
Composition.relatesTo.code	Base	required	DocumentRelationshipType	📍4.0.1	FHIR Std.
Composition.relatesTo:replaced_document.code	Base	required	DocumentRelationshipType	📍4.0.1	FHIR Std.
Composition.relatesTo:replaced_document.target[x]:targetIdentifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Composition.relatesTo:appended_document.code	Base	required	DocumentRelationshipType	📍4.0.1	FHIR Std.
Composition.relatesTo:appended_document.target[x]:targetIdentifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Composition.section.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:advance_directive_source_form.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:healthcare_agent.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:healthcare_agent.emptyReason	Base	required	No Healthcare Agent Included Reason	📦2.0.0	This IG
Composition.section:gpp_for_certain_health_condition.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_personal_care_experience.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_upon_death.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:additional_documentation.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:witness_and_notary.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:administrative_information.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
Composition-section-code-equals-type	error	Composition	Composition section code must equal Composition type when section is portable_medical_orders	`section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type`
HCA-section-cardinality	error	Composition	If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)	`(type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1`
HCA-section-emptyReason-required	error	Composition	section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.	`section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists()`
HCA-section-entries	error	Composition.section:healthcare_agent	If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist	`entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists())`
clindoc-limit-participantType	error	Composition	The R4 FHIR Clinical Document Composition Profile contains specific extensions for data entry person, informant, information recipient, primary information recipient and tracker. So, they are not allowed in the participant extension in the R4 profile. In R6, the intention is to have dedicated-named slices of a backbone element.	extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='ENT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='INF').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='IRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='PRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='TRC').not()
cmp-1	error	Composition.section, Composition.section:advance_directive_source_form, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information	A section must contain at least one of text, entries, or sub-sections	`text.exists() or entry.exists() or section.exists()`
cmp-2	error	Composition.section, Composition.section:advance_directive_source_form, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information	A section can only have an emptyReason if it is empty	`emptyReason.empty() or entry.empty()`
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	`contained.contained.empty()`
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	`contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label	`contained.meta.security.empty()`
dom-6	best practice	Composition	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children	`hasValue() or (children().count() > id.count())`
ext-1	error	Composition.extension:R5-Composition-version, Composition.extension:data-enterer, Composition.extension:informant, Composition.extension:information-recipient, Composition.extension:participant, Composition.extension:consent, Composition.extension:basedOn, Composition.extension:change-made, Composition.extension:ExpirationDateExtension, Composition.extension:DataEntererExtension, Composition.extension:InformantExtension, Composition.extension:ParticipantExtension, Composition.extension:PerformerExtension, Composition.extension:ClauseExtension, Composition.extension:DocumentRevokeStatus, Composition.modifierExtension, Composition.status.extension:R5-Composition-status, Composition.attester.modifierExtension, Composition.attester:legal_attester.modifierExtension, Composition.attester:professional_attester.modifierExtension, Composition.relatesTo.modifierExtension, Composition.relatesTo:replaced_document.modifierExtension, Composition.relatesTo:appended_document.modifierExtension, Composition.section.extension:change-made, Composition.section.extension:ClauseExtension, Composition.section.modifierExtension, Composition.section:advance_directive_source_form.extension:change-made, Composition.section:advance_directive_source_form.extension:ADISourceFormJurisdiction, Composition.section:advance_directive_source_form.modifierExtension, Composition.section:healthcare_agent.extension:change-made, Composition.section:healthcare_agent.modifierExtension, Composition.section:gpp_for_certain_health_condition.extension:change-made, Composition.section:gpp_for_certain_health_condition.modifierExtension, Composition.section:gpp_personal_care_experience.extension:change-made, Composition.section:gpp_personal_care_experience.modifierExtension, Composition.section:gpp_upon_death.extension:change-made, Composition.section:gpp_upon_death.modifierExtension, Composition.section:additional_documentation.extension:change-made, Composition.section:additional_documentation.modifierExtension, Composition.section:witness_and_notary.extension:change-made, Composition.section:witness_and_notary.modifierExtension, Composition.section:administrative_information.extension:change-made, Composition.section:administrative_information.modifierExtension	Must have either extensions or value[x], not both	`extension.exists() != value.exists()`

This structure is derived from ADICompositionHeader

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Composition	C	0..*	ADICompositionHeader	A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: HCA-section-cardinality, HCA-section-emptyReason-required, Composition-section-code-equals-type
Composition.type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Advance Directive Document Types (extensible)
Composition.category		1..*	CodeableConcept	Categorization of Composition Binding: Advance Healthcare Directive Categories LOINC (extensible)
Composition.author		1..*	Reference(US Core Patient Profile)	Who and/or what authored the composition
Composition.attester	This element must be supported.	1..*	BackboneElement	Attests to accuracy of composition
Composition.attester.mode		1..1	code	personal \| professional \| legal \| official Required Pattern: personal (extensions allowed)
Composition.attester.party		0..1	Reference(US Core Patient Profile \| RelatedPerson \| ADI Witness \| ADI Notary \| ADI Practitioner Role)	Who attested the composition
Composition.Slices for attester				Content/Rules for all slices
Composition.Slices for attester.attester:legal_attester		0..1	BackboneElement	aka legal authenticator
Composition.Slices for attester.attester:legal_attester.party		0..1	Reference(US Core Patient Profile \| RelatedPerson \| ADI Witness \| ADI Notary \| ADI Practitioner Role)	Who attested the composition
Composition.Slices for attester.attester:professional_attester		0..*	BackboneElement	aka authenticator
Composition.Slices for attester.attester:professional_attester.party		0..1	Reference(US Core Patient Profile \| RelatedPerson \| ADI Witness \| ADI Notary \| ADI Practitioner Role)	Who attested the composition
Composition.Slices for section		2..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by pattern:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Composition.Slices for section.section:healthcare_agent	This element must be supported. C	1..1	BackboneElement	Healthcare agents, healthcare agent advisors, and consent regarding their roles, powers, and limitations Constraints: HCA-section-entries
Composition.Slices for section.section:healthcare_agent.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "81335-2" } ] }`
Composition.Slices for section.section:healthcare_agent.entry		0..*	Reference(ADI Healthcare Agent Consent \| ADI Healthcare Agent Participant)	A reference to data that supports this section
Composition.Slices for section.section:healthcare_agent.emptyReason		0..1	CodeableConcept	This is only MS (must support) if the document types are supported. Binding: No Healthcare Agent Included Reason (required)
Composition.Slices for section.section:gpp_for_certain_health_condition		0..1	BackboneElement	Preference care plans defined for specific situations and/or conditions
Composition.Slices for section.section:gpp_for_certain_health_condition.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "107905-2" } ] }`
Composition.Slices for section.section:gpp_for_certain_health_condition.entry		0..*	Reference(ADI Person-Authored Preference Care Plan \| ADI Person Authored Personal Intervention Preference \| ADI Personal Priorities Organizer \| ADI Personal Goal)	A reference to data that supports this section
Composition.Slices for section.section:gpp_personal_care_experience		0..1	BackboneElement	Quality of Life related personal care experiences, personal goals, and priorities
Composition.Slices for section.section:gpp_personal_care_experience.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "81338-6" } ] }`
Composition.Slices for section.section:gpp_personal_care_experience.entry		0..*	Reference(ADI Person-Authored Care Experience Preference \| ADI Personal Priorities Organizer \| ADI Personal Goal)	A reference to data that supports this section
Composition.Slices for section.section:gpp_upon_death		0..1	BackboneElement	Goals, preferences, and priorities upon death
Composition.Slices for section.section:gpp_upon_death.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "81337-8" } ] }`
Composition.Slices for section.section:gpp_upon_death.entry		0..*	Reference(ADI Person Authored Personal Intervention Preference \| ADI Personal Priorities Organizer \| ADI Autopsy Observation \| ADI Organ Donation Observation \| ADI Personal Goal \| ADI Upon Death Preferences)	A reference to data that supports this section
Composition.Slices for section.section:additional_documentation		0..1	BackboneElement	Observations regarding the existence of other advance directive related information
Composition.Slices for section.section:additional_documentation.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "77599-9" } ] }`
Composition.Slices for section.section:additional_documentation.entry		0..*	Reference(US Core Observation ADI Documentation Profile)	A reference to data that supports this section
Composition.Slices for section.section:witness_and_notary		0..1	BackboneElement	Witness and notary information. The first witness should be the author of the document
Composition.Slices for section.section:witness_and_notary.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "81339-4" } ] }`
Composition.Slices for section.section:witness_and_notary.entry		0..*	Reference(ADI Witness \| ADI Notary)	A reference to data that supports this section
Composition.Slices for section.section:administrative_information		0..1	BackboneElement	Administrative information associated with this personal advance care plan
Composition.Slices for section.section:administrative_information.code		1..1	CodeableConcept	Classification of section (recommended) Required Pattern: `{ "coding" : [ { "system" : "http://loinc.org", "code" : "107904-5" } ] }`
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Composition.type	Base	extensible	Advance Directive Document Types	⏿20240712	tx.fhir.org
Composition.category	Base	extensible	Advance Healthcare Directive Categories LOINC	⏿20260912	tx.fhir.org
Composition.section:healthcare_agent.emptyReason	Base	required	No Healthcare Agent Included Reason	📦2.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
Composition-section-code-equals-type	error	Composition	Composition section code must equal Composition type when section is portable_medical_orders	`section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type`
HCA-section-cardinality	error	Composition	If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)	`(type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1`
HCA-section-emptyReason-required	error	Composition	section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.	`section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists()`
HCA-section-entries	error	Composition.section:healthcare_agent	If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist	`entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists())`

Description & Constraints Filter:

Composition.id This element is included in summaries. 0..1 id Logical id of this artifact

Composition.meta This element is included in summaries. 0..1 Meta Metadata about the resource

Composition.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created

language

1..1

code

Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional Bindings

Purpose

AllLanguages

Max Binding

Composition.contained 0..* Resource Contained, inline Resources

Composition.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for extension.extension:consent 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension

Composition.Slices for extension.extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension

Composition.Slices for extension.extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Composition.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored

Composition.identifier This element must be supported. This element is included in summaries. 1..1 Identifier Version-independent identifier for the Composition

Composition.status.id 0..1 string xml:id (or equivalent in JSON)

Composition.status.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.status.value 0..1 string Primitive value for code

category:clinicalnotecategory

0..1

CodeableConcept

Category for Clinical Note
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107903-7",
      "display" : "Clinical note"
    }
  ]
}

category:advanceDirectiveCategory

1..1

CodeableConcept

Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC

(extensible)

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "42348-3",
      "display" : "Advance healthcare directives"
    }
  ]
}

Composition.subject This element must be supported. This element is included in summaries. 1..1 Reference(US Core Patient Profile) Who and/or what the composition is about

Composition.encounter This element is included in summaries. 0..1 Reference(US Core Encounter Profile) Context of the Composition

Composition.date This element must be supported. This element is included in summaries. 1..1 dateTime Composition editing time

Composition.author This element must be supported. This element is included in summaries. 1..* Reference(US Core Patient Profile) Who and/or what authored the composition

Composition.title This element must be supported. This element is included in summaries. 1..1 string Human Readable name/title

Composition.Slices for attester.attester:All Slices Content/Rules for all slices

Composition.Slices for attester.attester:All Slices.id 0..1 string Unique id for inter-element referencing

Composition.Slices for attester.attester:All Slices.extension 0..* Extension Additional content defined by implementations

Composition.Slices for attester.attester:All Slices.time 0..1 dateTime When the composition was attested

Composition.Slices for attester.attester:All Slices.party 0..1 Reference(US Core Patient Profile | RelatedPerson | ADI Witness | ADI Notary | ADI Practitioner Role) Who attested the composition

Composition.Slices for attester.attester:legal_attester 0..1 BackboneElement aka legal authenticator

Composition.Slices for attester.attester:legal_attester.id 0..1 string Unique id for inter-element referencing

Composition.Slices for attester.attester:legal_attester.extension 0..* Extension Additional content defined by implementations

Composition.Slices for attester.attester:legal_attester.time 0..1 dateTime When the composition was attested

Composition.Slices for attester.attester:legal_attester.party 0..1 Reference(US Core Patient Profile | RelatedPerson | ADI Witness | ADI Notary | ADI Practitioner Role) Who attested the composition

Composition.Slices for attester.attester:professional_attester 0..* BackboneElement aka authenticator

Composition.Slices for attester.attester:professional_attester.id 0..1 string Unique id for inter-element referencing

Composition.Slices for attester.attester:professional_attester.extension 0..* Extension Additional content defined by implementations

Composition.Slices for attester.attester:professional_attester.time 0..1 dateTime When the composition was attested

Composition.custodian This element must be supported. This element is included in summaries. 1..1 Reference(US Core Organization Profile) Organization which maintains the composition

Composition.Slices for relatesTo.relatesTo:All Slices Content/Rules for all slices

Composition.Slices for relatesTo.relatesTo:All Slices.id 0..1 string Unique id for inter-element referencing

Composition.Slices for relatesTo.relatesTo:All Slices.extension 0..* Extension Additional content defined by implementations

Composition.Slices for relatesTo.relatesTo:All Slices.code 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x] 1..1 Target of the relationship
Slice: Unordered, Open by type:$this

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x].targetIdentifier Identifier

Composition.Slices for relatesTo.relatesTo:All Slices.Slices for target[x].targetReference Reference(Composition)

Composition.Slices for relatesTo.relatesTo:replaced_document 0..* BackboneElement The document(s) being superceded

Composition.Slices for relatesTo.relatesTo:replaced_document.id 0..1 string Unique id for inter-element referencing

Composition.Slices for relatesTo.relatesTo:replaced_document.extension 0..* Extension Additional content defined by implementations

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x] Content/Rules for all slices

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.id 0..1 string Unique id for inter-element referencing

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use

Composition.Slices for relatesTo.relatesTo:replaced_document.Slices for target[x].target[x]:targetIdentifier.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)

Composition.Slices for relatesTo.relatesTo:appended_document 0..* BackboneElement The document(s) being appended too

Composition.Slices for relatesTo.relatesTo:appended_document.id 0..1 string Unique id for inter-element referencing

Composition.Slices for relatesTo.relatesTo:appended_document.extension 0..* Extension Additional content defined by implementations

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x] 1..1 Identifier Target of the relationship
Slice: Unordered, Closed by type:$this

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x] Content/Rules for all slices

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier 1..1 Identifier Target of the relationship

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.id 0..1 string Unique id for inter-element referencing

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.system This element is included in summaries. 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.value This element is included in summaries. 0..1 string The value that is unique
Example General: 123456

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use

Composition.Slices for relatesTo.relatesTo:appended_document.Slices for target[x].target[x]:targetIdentifier.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)

Composition.event This element is included in summaries. 0..* BackboneElement The clinical service(s) being documented

Composition.event.id 0..1 string Unique id for inter-element referencing

Composition.event.extension 0..* Extension Additional content defined by implementations

Composition.event.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized

code

0..*

CodeableConcept

Code(s) that apply to the event being documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs",
      "code" : "acp-services",
      "display" : "Advance care planning services"
    }
  ]
}

Composition.event.period This element is included in summaries. 0..1 Period The period covered by the documentation

Composition.event.Slices for detail This element is included in summaries. 0..* Reference(Resource) The event(s) being documented
Slice: Unordered, Open by profile:resolve()

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Composition.event.Slices for detail.detail:adiFacilitator This element is included in summaries. 0..1 Reference(ADI Facilitator) ADI Facilitator

Composition.Slices for section.section:All Slices Content/Rules for all slices

Composition.Slices for section.section:All Slices.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:All Slices.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:All Slices.Slices for extension.extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Composition.Slices for section.section:All Slices.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

Composition.Slices for section.section:All Slices.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:All Slices.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:All Slices.entry C 0..* Reference(Resource) A reference to data that supports this section

Composition.Slices for section.section:All Slices.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:All Slices.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:advance_directive_source_form This element must be supported. C 1..1 BackboneElement Advance directive source form
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:advance_directive_source_form.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:advance_directive_source_form.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:advance_directive_source_form.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:advance_directive_source_form.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs",
      "code" : "advance_directive_source_form"
    }
  ]
}

Composition.Slices for section.section:advance_directive_source_form.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:advance_directive_source_form.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:advance_directive_source_form.entry C 0..* Reference(ADI Source Form) A reference to data that supports this section

Composition.Slices for section.section:advance_directive_source_form.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:advance_directive_source_form.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:healthcare_agent.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:healthcare_agent.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:healthcare_agent.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:healthcare_agent.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81335-2"
    }
  ]
}

Composition.Slices for section.section:healthcare_agent.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:healthcare_agent.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:healthcare_agent.entry C 0..* Reference(ADI Healthcare Agent Consent | ADI Healthcare Agent Participant) A reference to data that supports this section

Composition.Slices for section.section:healthcare_agent.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:gpp_for_certain_health_condition.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:gpp_for_certain_health_condition.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:gpp_for_certain_health_condition.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:gpp_for_certain_health_condition.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107905-2"
    }
  ]
}

Composition.Slices for section.section:gpp_for_certain_health_condition.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:gpp_for_certain_health_condition.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:gpp_for_certain_health_condition.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:gpp_for_certain_health_condition.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:gpp_personal_care_experience.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:gpp_personal_care_experience.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:gpp_personal_care_experience.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:gpp_personal_care_experience.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81338-6"
    }
  ]
}

Composition.Slices for section.section:gpp_personal_care_experience.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:gpp_personal_care_experience.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:gpp_personal_care_experience.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:gpp_personal_care_experience.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:gpp_upon_death This element must be supported. C 0..1 BackboneElement Goals, preferences, and priorities upon death
Constraints: cmp-1, cmp-2

Composition.Slices for section.section:gpp_upon_death.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:gpp_upon_death.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:gpp_upon_death.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:gpp_upon_death.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81337-8"
    }
  ]
}

Composition.Slices for section.section:gpp_upon_death.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:gpp_upon_death.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:gpp_upon_death.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:gpp_upon_death.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:additional_documentation.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:additional_documentation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:additional_documentation.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:additional_documentation.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "77599-9"
    }
  ]
}

Composition.Slices for section.section:additional_documentation.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:additional_documentation.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:additional_documentation.entry C 0..* Reference(US Core Observation ADI Documentation Profile) A reference to data that supports this section

Composition.Slices for section.section:additional_documentation.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:additional_documentation.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:witness_and_notary.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:witness_and_notary.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:witness_and_notary.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:witness_and_notary.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "81339-4"
    }
  ]
}

Composition.Slices for section.section:witness_and_notary.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:witness_and_notary.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:witness_and_notary.entry C 0..* Reference(ADI Witness | ADI Notary) A reference to data that supports this section

Composition.Slices for section.section:witness_and_notary.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:witness_and_notary.section C 0..* See section (Composition) Nested Section

Composition.Slices for section.section:administrative_information.id 0..1 string Unique id for inter-element referencing

Composition.Slices for section.section:administrative_information.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Composition.Slices for section.section:administrative_information.Slices for extension Content/Rules for all slices

Composition.Slices for section.section:administrative_information.title This element must be supported. 1..1 string Label for section (e.g. for ToC)

code

1..1

CodeableConcept

Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107904-5"
    }
  ]
}

Composition.Slices for section.section:administrative_information.focus 0..1 Reference(Resource) Who/what the section is about, when it is not about the subject of composition

Composition.Slices for section.section:administrative_information.mode 0..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this section.

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

Composition.Slices for section.section:administrative_information.entry C 0..* Reference(Resource) A reference to data that supports this section

Composition.Slices for section.section:administrative_information.emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

Composition.Slices for section.section:administrative_information.section C 0..* See section (Composition) Nested Section

Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Composition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Composition.status	Base	required	ADI Composition Status	📦2.0.0	This IG
Composition.type	Base	extensible	Advance Directive Document Types	⏿20240712	tx.fhir.org
Composition.category	Base	extensible	Advance Healthcare Directive Categories LOINC	⏿20260912	tx.fhir.org
Composition.category:clinicalnotecategory	Base	example	Document Class Value Set	📍4.0.1	FHIR Std.
Composition.category:advanceDirectiveCategory	Base	extensible	Advance Healthcare Directive Categories LOINC	⏿20260912	tx.fhir.org
Composition.attester.mode	Base	required	CompositionAttestationMode	📍4.0.1	FHIR Std.
Composition.attester:legal_attester.mode	Base	required	CompositionAttestationMode	📍4.0.1	FHIR Std.
Composition.attester:professional_attester.mode	Base	required	CompositionAttestationMode	📍4.0.1	FHIR Std.
Composition.relatesTo.code	Base	required	DocumentRelationshipType	📍4.0.1	FHIR Std.
Composition.relatesTo:replaced_document.code	Base	required	DocumentRelationshipType	📍4.0.1	FHIR Std.
Composition.relatesTo:replaced_document.target[x]:targetIdentifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Composition.relatesTo:replaced_document.target[x]:targetIdentifier.type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Composition.relatesTo:appended_document.code	Base	required	DocumentRelationshipType	📍4.0.1	FHIR Std.
Composition.relatesTo:appended_document.target[x]:targetIdentifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Composition.relatesTo:appended_document.target[x]:targetIdentifier.type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Composition.event.code	Base	example	v3 Code System ActCode	📦3.0.0	THO v7.4
Composition.section.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:advance_directive_source_form.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:advance_directive_source_form.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:advance_directive_source_form.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:advance_directive_source_form.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:healthcare_agent.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:healthcare_agent.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:healthcare_agent.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:healthcare_agent.emptyReason	Base	required	No Healthcare Agent Included Reason	📦2.0.0	This IG
Composition.section:gpp_for_certain_health_condition.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_for_certain_health_condition.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:gpp_for_certain_health_condition.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_for_certain_health_condition.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:gpp_personal_care_experience.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_personal_care_experience.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:gpp_personal_care_experience.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_personal_care_experience.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:gpp_upon_death.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_upon_death.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:gpp_upon_death.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:gpp_upon_death.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:additional_documentation.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:additional_documentation.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:additional_documentation.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:additional_documentation.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:witness_and_notary.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:witness_and_notary.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:witness_and_notary.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:witness_and_notary.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.
Composition.section:administrative_information.code	Base	example	Document Section Codes	📍4.0.1	FHIR Std.
Composition.section:administrative_information.mode	Base	required	ListMode	📍4.0.1	FHIR Std.
Composition.section:administrative_information.orderedBy	Base	preferred	List Order Codes	📍4.0.1	FHIR Std.
Composition.section:administrative_information.emptyReason	Base	preferred	List Empty Reasons	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
Composition-section-code-equals-type	error	Composition	Composition section code must equal Composition type when section is portable_medical_orders	`section.where(code.coding.code = 'portable_medical_orders').exists() implies section.where(code.coding.code = 'portable_medical_orders').code = type`
HCA-section-cardinality	error	Composition	If the PACP Composition document type is equal to Power of attorney (64298-3), Patient Personal advance care plan (81334-5), or Power of attorney and Living will (92664-2), then the PACP Composition requires one and only one healthcare agent section slice with code = 81335-2 (Patient Healthcare agent)	`(type.coding.where(code = '64298-3').exists().not() and type.coding.where(code = '81334-5').exists().not() and type.coding.where(code = '92664-2').exists().not()) or section.where(code.coding.where(code = '81335-2').exists()).count() = 1`
HCA-section-emptyReason-required	error	Composition	section[healthcare_agent].emptyReason is required if section[healthcare_agent] is present and there are no entries.	`section.where(code.coding.where(code = '81335-2').exists()).exists().not() or section.where(code.coding.where(code = '81335-2').exists()).entry.count() > 0 or section.where(code.coding.where(code = '81335-2').exists()).emptyReason.exists()`
HCA-section-entries	error	Composition.section:healthcare_agent	If healthcare agent section entry exists, then the HCA consent entry and HCA RelatedPerson entry must exist	`entry.exists().not() or (entry.where($this.resolve() is Consent).exists() and entry.where($this.resolve() is RelatedPerson).exists())`
clindoc-limit-participantType	error	Composition	The R4 FHIR Clinical Document Composition Profile contains specific extensions for data entry person, informant, information recipient, primary information recipient and tracker. So, they are not allowed in the participant extension in the R4 profile. In R6, the intention is to have dedicated-named slices of a backbone element.	extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='ENT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='INF').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='IRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='PRCP').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='TRC').not()
cmp-1	error	Composition.section, Composition.section:advance_directive_source_form, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information	A section must contain at least one of text, entries, or sub-sections	`text.exists() or entry.exists() or section.exists()`
cmp-2	error	Composition.section, Composition.section:advance_directive_source_form, Composition.section:healthcare_agent, Composition.section:gpp_for_certain_health_condition, Composition.section:gpp_personal_care_experience, Composition.section:gpp_upon_death, Composition.section:additional_documentation, Composition.section:witness_and_notary, Composition.section:administrative_information	A section can only have an emptyReason if it is empty	`emptyReason.empty() or entry.empty()`
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	`contained.contained.empty()`
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	`contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label	`contained.meta.security.empty()`
dom-6	best practice	Composition	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children	`hasValue() or (children().count() > id.count())`
ext-1	error	ALL extensions	Must have either extensions or value[x], not both	`extension.exists() != value.exists()`

This structure is derived from ADICompositionHeader

Summary

Mandatory: 3 elements(6 nested mandatory elements)
Must-Support: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

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

Key Elements View

Description & Constraints Filter:

Composition.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created

language

1..1

code

Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional Bindings

Purpose

AllLanguages

Max Binding

Composition.Slices for extension Content/Rules for all slices

Composition.Slices for extension.extension:consent 0..* Reference(Consent) consent
URL: http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension

Composition.Slices for extension.extension:ExpirationDateExtension 0..1 dateTime ADI Expiration Date
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension

Composition.Slices for extension.extension:ClauseExtension 0..* (Complex) Clause
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Composition.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored

Composition.identifier This element must be supported. This element is included in summaries. 1..1 Identifier Version-independent identifier for the Composition

Composition.status.Slices for extension Content/Rules for all slices

category:clinicalnotecategory

0..1

CodeableConcept

Category for Clinical Note
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "107903-7",
      "display" : "Clinical note"
    }
  ]
}

category:advanceDirectiveCategory

1..1

CodeableConcept

Categorization of Composition
Binding: Advance Healthcare Directive Categories LOINC

(extensible)

Required Pattern:

{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "42348-3",
      "display" : "Advance healthcare directives"
    }
  ]
}