PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0 - STU 2 – Ballot
PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0 - STU 2 – Ballot
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
| Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-attester | Version: 2.0.0 | |||
| Standards status: Trial-use | Computable Name: ADIAttester | |||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.68.42.37 | ||||
An advance healthcare directive attester is a person (typically a witness or notary) who formally verifies and confirms that an individual has voluntarily signed an advance healthcare directive—a legal document outlining their wishes for medical treatment if they become unable to communicate those decisions themselves. The attester's role is to authenticate that the directive was executed properly, that the signer appeared competent, and that no undue influence or coercion was involved.
Context of Use
This extension may be used on the following element(s)
DocumentReference
Usage info
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  Extension |
0..* | Extension | ADI Attester | |
  Slices for extension |
Content/Rules for all slices | |||
   extension:mode |
0..1 | Extension | mode | |
   extension |
0..0 | Extension | ||
| url |
1..1 | uri | "mode" | |
  value[x] |
0..1 | code | Value of extension Binding: CompositionAttestationMode (required) | |
| extension:time |
0..1 | Extension | attestation or authentication time | |
| extension |
0..0 | Extension | ||
| url |
1..1 | uri | "time" | |
| value[x] |
0..1 | dateTime | Value of extension | |
 extension:party |
0..1 | Extension | attester party | |
 extension |
0..0 | Extension | ||
| url |
1..1 | uri | "party" | |
 value[x] |
0..1 | Reference(US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Value of extension | |
 url |
1..1 | uri | "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-attester" | |
 value[x] |
0..0 | Value of extension | ||
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Extension |
0..* | Extension | ADI Attester | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| extension:mode |
0..1 | Extension | mode | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||
| url |
1..1 | uri | "mode" | |
| value[x] |
0..1 | code | Value of extension Binding: CompositionAttestationMode (required) | |
| extension:time |
0..1 | Extension | attestation or authentication time | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||
| url |
1..1 | uri | "time" | |
| value[x] |
0..1 | dateTime | Value of extension | |
| extension:party |
0..1 | Extension | attester party | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||
| url |
1..1 | uri | "party" | |
| value[x] |
0..1 | Reference(US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Value of extension | |
| url |
1..1 | uri | "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-attester" | |
| Documentation for this format | ||||
This structure is derived from Extension
Summary
Complex Extension: An advance healthcare directive attester is a person (typically a witness or notary) who formally verifies and confirms that an individual has voluntarily signed an advance healthcare directive—a legal document outlining their wishes for medical treatment if they become unable to communicate those decisions themselves. The attester's role is to authenticate that the directive was executed properly, that the signer appeared competent, and that no undue influence or coercion was involved.
Differential View
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Extension |
0..* | Extension | ADI Attester | |
| Slices for extension |
Content/Rules for all slices | |||
| extension:mode |
0..1 | Extension | mode | |
| extension |
0..0 | Extension | ||
| url |
1..1 | uri | "mode" | |
| value[x] |
0..1 | code | Value of extension Binding: CompositionAttestationMode (required) | |
| extension:time |
0..1 | Extension | attestation or authentication time | |
| extension |
0..0 | Extension | ||
| url |
1..1 | uri | "time" | |
| value[x] |
0..1 | dateTime | Value of extension | |
| extension:party |
0..1 | Extension | attester party | |
| extension |
0..0 | Extension | ||
| url |
1..1 | uri | "party" | |
| value[x] |
0..1 | Reference(US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Value of extension | |
| url |
1..1 | uri | "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-attester" | |
| value[x] |
0..0 | Value of extension | ||
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Extension |
0..* | Extension | ADI Attester | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| extension:mode |
0..1 | Extension | mode | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||
| url |
1..1 | uri | "mode" | |
| value[x] |
0..1 | code | Value of extension Binding: CompositionAttestationMode (required) | |
| extension:time |
0..1 | Extension | attestation or authentication time | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||
| url |
1..1 | uri | "time" | |
| value[x] |
0..1 | dateTime | Value of extension | |
| extension:party |
0..1 | Extension | attester party | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||
| url |
1..1 | uri | "party" | |
| value[x] |
0..1 | Reference(US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson) | Value of extension | |
| url |
1..1 | uri | "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-attester" | |
| Documentation for this format | ||||
This structure is derived from Extension
Summary
Complex Extension: An advance healthcare directive attester is a person (typically a witness or notary) who formally verifies and confirms that an individual has voluntarily signed an advance healthcare directive—a legal document outlining their wishes for medical treatment if they become unable to communicate those decisions themselves. The attester's role is to authenticate that the directive was executed properly, that the signer appeared competent, and that no undue influence or coercion was involved.
Other representations of profile: CSV, Excel, Schematron
| Path | Status | Usage | ValueSet | Version | Source |
| Extension.extension:mode.value[x] | Base | required | CompositionAttestationMode | 📦4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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()
|
IG © 2021+ HL7 International / Patient Empowerment. Package hl7.fhir.us.pacio-adi#2.0.0 based on FHIR 4.0.1. Generated 2026-10-15
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