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FHIRcast, published by HL7 International / Infrastructure And Messaging. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhircast-docs/ and changes regularly. See the Directory of published versions

Resource Profile: FHIRcastImagingStudyOpen - XML Profile

Draft as of 2024-11-22

XML representation of the fhircast-imaging-study-open resource profile.

Raw xml | Download


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="fhircast-imaging-study-open"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition fhircast-imaging-study-open</b></p><a name="fhircast-imaging-study-open"> </a><a name="hcfhircast-imaging-study-open"> </a><a name="fhircast-imaging-study-open-en-US"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-fhircast-imaging-study-open-definitions.html#ImagingStudy">ImagingStudy</a><a name="ImagingStudy"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/imagingstudy.html">ImagingStudy</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-fhircast-imaging-study-open-definitions.html#ImagingStudy.id" title="A logical id of the resource SHALL be provided. It may be the `id` associated with the resource as persisted in a FHIR server.  If the resource is not stored in a FHIR server, the Subscriber requesting the context change SHOULD use a mechanism to generate the `id` such that it will be globally unique (e.g., a [UUID](https://en.wikipedia.org/wiki/Universally_unique_identifier)).  When a [FHIR resource]-close event including this image study is requested, the Subscriber requesting the context be closed SHALL use the same ImagingStudy resource `id` which was provided in the [FHIR resource]-open event (see also [FHIRcast ImagingStudy for Close Events](StructureDefinition-fhircast-imaging-study-close.html)).">id</a><a name="ImagingStudy.id"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#id">id</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">A logical id of the resource SHALL be provided.</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-fhircast-imaging-study-open-definitions.html#ImagingStudy.identifier" title="The Study Instance UID SHALL be included as a business identifier if it is known.  In FHIR, the Study Instance UID of an ImagingStudy is stored in the `identifier` array using the identifier system of `urn:dicom:uid` and prefixing the UID value with `urn:oid:`.

The accession number of the order which triggered the image procedure to be performed SHALL be included as a business identifier if it is known.  The accession number is provided using the “ACSN” identifier type.">identifier</a><a name="ImagingStudy.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">At least one business identifier of the ImagingStudy SHALL be provided in a [FHIR resource]-open request (see this event's detailed description for more information).</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-fhircast-imaging-study-open-definitions.html#ImagingStudy.status">status</a><a name="ImagingStudy.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Status of the ImagingStudy, note this may not be known and hence have a value of `unknown`; however, `status` is included since it is required by the FHIR standard</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-fhircast-imaging-study-open-definitions.html#ImagingStudy.subject" title="A reference to the FHIR Patient resource describing the patient whose imaging study is currently in context.  A patient SHALL be present if there is a patient associated with the study.  Note there are rare cases in which the ImagingStudy.subject references a resource which is not a patient; for example a calibration study.  A reference to the related non-Patient subject of the study SHALL be present in the ImagingStudy resource as it is required by the FHIR specification but is not required to be present in the [FHIR resource]-open event's context.  For example, a reference to a Device resource could be provided as the subject (note, if no FHIR Device FHIR resource instance is available it is allowed to provide only a `display` value in the `reference`) but not provided in the FHIRcast event's `context` array.">subject</a><a name="ImagingStudy.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-fhircast-patient-open.html">FHIRcast Patient for Open Events</a> | <a href="http://hl7.org/fhir/R4/device.html">Device</a> | <a href="http://hl7.org/fhir/R4/group.html">Group</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Reference to the Patient resource associated with the ImagingStudy (see detailed description if the image study's subject is not a patient)</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="inm"/>
  </extension>
  <url
       value="http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-imaging-study-open"/>
  <version value="3.0.0-ballot"/>
  <name value="FHIRcastImagingStudyOpen"/>
  <title value="FHIRcast ImagingStudy for Open Events"/>
  <status value="draft"/>
  <date value="2024-11-22T16:49:57+00:00"/>
  <publisher value="HL7 International / Infrastructure And Messaging"/>
  <contact>
    <name value="HL7 International / Infrastructure And Messaging"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/inm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="inm@lists.HL7.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="HL7 International / Infrastructure And Messaging"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/inm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="inm@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="Provides guidance as to which ImagingStudy attributes should be present and considerations as to how each attribute should be valued in all [FHIR resource]-open events.

At least one business identifier of the ImagingStudy SHALL be provided in a [FHIR resource]-open request.  Two business identifiers are typically associated with an image study.  Imaging systems such as a PACS viewer, advanced visualization workstation, etc. typically identify an image study by its DICOM Study Instance UID (which in DICOM is identified with a (0020,000D) tag).  Likewise, information systems often identify an image study through the accession number of the order which triggered the image procedure to be performed.

The Study Instance UID SHALL be included as a business identifier if it is known.  In FHIR, the Study Instance UID of an ImagingStudy is provided in the `identifier` array using the identifier system of `urn:dicom:uid` and prefixing the UID value with `urn:oid:`.

The accession number SHALL be included as a business identifier if it is known.

**FHIR R4 versus FHIR R5**

Relative to FHIR R4, the ImagingStudy resource's change relevant to FHIRcast is the guidance FHIR R5 provides in specifying the accession number.  In FHIR R4, the guidance is to provide the accession number in the `identifier` array.  In FHIR R5, the accession number is provided in the ImagingStudy's `basedOn` array as a reference using a ServiceRequest reference type.

Since this version of FHIRcast promotes the use of FHIR R4 resources, the guidance to provide the accession number in the `identifier` array SHOULD be used and this approach is shown in all ImagingStudy examples in the FHIRcast specification.  However, if Subscribers agree to use FHIR R5 resources, the FHIR R5 recommendation MAY be used.

For a more detailed explanation of these business identifiers, see the [FHIR R4 implementation notes of the FHIR ImagingStudy resource](https://hl7.org/fhir/R4B/imagingstudy.html) (and the [FHIR R5 implementation notes of the FHIR ImagingStudy resource](https://hl7.org/fhir/R5/imagingstudy.html)). Ideally both the accession number and Study Instance UID are available and present in an ImagingStudy resource used in FHIRcast.  The presence of both business identifiers ensures that all Subscribers will be able to be able to identify the appropriate imaging study."/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="dicom"/>
    <uri value="http://nema.org/dicom"/>
    <name value="DICOM Tag Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="ImagingStudy"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="ImagingStudy">
      <path value="ImagingStudy"/>
      <short
             value="A set of images produced in single study (one or more series of references images)"/>
      <definition
                  value="Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context.  A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="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"/>
        <expression
                    value="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()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human
               value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act[classCode=COMPOSITION, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="Reference IHE radiology TF vol 2 table 4.14-1"/>
      </mapping>
    </element>
    <element id="ImagingStudy.id">
      <path value="ImagingStudy.id"/>
      <short value="A logical id of the resource SHALL be provided."/>
      <definition
                  value="A logical id of the resource SHALL be provided. It may be the `id` associated with the resource as persisted in a FHIR server.  If the resource is not stored in a FHIR server, the Subscriber requesting the context change SHOULD use a mechanism to generate the `id` such that it will be globally unique (e.g., a [UUID](https://en.wikipedia.org/wiki/Universally_unique_identifier)).  When a [FHIR resource]-close event including this image study is requested, the Subscriber requesting the context be closed SHALL use the same ImagingStudy resource `id` which was provided in the [FHIR resource]-open event (see also [FHIRcast ImagingStudy for Close Events](StructureDefinition-fhircast-imaging-study-close.html))."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="ImagingStudy.meta">
      <path value="ImagingStudy.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="ImagingStudy.implicitRules">
      <path value="ImagingStudy.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="ImagingStudy.language">
      <path value="ImagingStudy.language"/>
      <short value="Language of the resource content"/>
      <definition
                  value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="ImagingStudy.text">
      <path value="ImagingStudy.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="ImagingStudy.contained">
      <path value="ImagingStudy.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.extension">
      <path value="ImagingStudy.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.modifierExtension">
      <path value="ImagingStudy.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.identifier">
      <path value="ImagingStudy.identifier"/>
      <short
             value="At least one business identifier of the ImagingStudy SHALL be provided in a [FHIR resource]-open request (see this event's detailed description for more information)."/>
      <definition
                  value="The Study Instance UID SHALL be included as a business identifier if it is known.  In FHIR, the Study Instance UID of an ImagingStudy is stored in the `identifier` array using the identifier system of `urn:dicom:uid` and prefixing the UID value with `urn:oid:`.

The accession number of the order which triggered the image procedure to be performed SHALL be included as a business identifier if it is known.  The accession number is provided using the “ACSN” identifier type."/>
      <comment
               value="See discussion under [Imaging Study Implementation Notes](http://hl7.org/fhir/R4/imagingstudy.html#notes) for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type."/>
      <requirements
                    value="If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see [DICOM PS 3.3 C.7.2](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.2.html)."/>
      <alias value="StudyInstanceUID"/>
      <alias value="AccessionNumber"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".id and .inboundRelationship[typeCode=COMP].source[classCode=ACSN, moodCode=EVN].id"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map
             value="StudyInstanceUID (0020,000D) | Accession Number and Issuer (0080,0050)+(0080,0051) | Study ID (0020,0010)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.status">
      <path value="ImagingStudy.status"/>
      <short
             value="Status of the ImagingStudy, note this may not be known and hence have a value of `unknown`; however, `status` is included since it is required by the FHIR standard"/>
      <definition value="The current state of the ImagingStudy."/>
      <comment
               value="Unknown does not represent &quot;other&quot; - one of the defined statuses must apply.  Unknown is used when the authoring system is not sure what the current status is."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingStudyStatus"/>
        </extension>
        <strength value="required"/>
        <description value="The status of the ImagingStudy."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="Varies by domain"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".status"/>
      </mapping>
    </element>
    <element id="ImagingStudy.modality">
      <path value="ImagingStudy.modality"/>
      <short value="All series modality if actual acquisition modalities"/>
      <definition
                  value="A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19)."/>
      <alias value="ModalitiesInStudy"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.modality"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingModality"/>
        </extension>
        <strength value="extensible"/>
        <description value="Type of acquired data in the instance."/>
        <valueSet
                  value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0061)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.subject">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString
                     value="dicom=http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.2.2.html"/>
      </extension>
      <path value="ImagingStudy.subject"/>
      <short
             value="Reference to the Patient resource associated with the ImagingStudy (see detailed description if the image study's subject is not a patient)"/>
      <definition
                  value="A reference to the FHIR Patient resource describing the patient whose imaging study is currently in context.  A patient SHALL be present if there is a patient associated with the study.  Note there are rare cases in which the ImagingStudy.subject references a resource which is not a patient; for example a calibration study.  A reference to the related non-Patient subject of the study SHALL be present in the ImagingStudy resource as it is required by the FHIR specification but is not required to be present in the [FHIR resource]-open event's context.  For example, a reference to a Device resource could be provided as the subject (note, if no FHIR Device FHIR resource instance is available it is allowed to provide only a `display` value in the `reference`) but not provided in the FHIRcast event's `context` array."/>
      <comment
               value="QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-patient-open"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0010/*)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
    </element>
    <element id="ImagingStudy.encounter">
      <path value="ImagingStudy.encounter"/>
      <short value="Encounter with which this imaging study is associated"/>
      <definition
                  value="The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made."/>
      <comment
               value="This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.encounter"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.context"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.started">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString
                     value="dicom=http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.2.html#sect_C.7.2.1"/>
      </extension>
      <path value="ImagingStudy.started"/>
      <short value="When the study was started"/>
      <definition value="Date and time the study started."/>
      <alias value="StudyDate"/>
      <alias value="StudyTime"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.started"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <example>
        <label value="General"/>
        <valueDateTime value="2011-01-01T11:01:20+03:00"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.init"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0020)+(0008,0030)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.basedOn">
      <path value="ImagingStudy.basedOn"/>
      <short value="Request fulfilled"/>
      <definition
                  value="A list of the diagnostic requests that resulted in this imaging study being performed."/>
      <requirements
                    value="To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Appointment"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/AppointmentResponse"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Task"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.basedOn"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.cause"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0032,1064)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.referrer">
      <path value="ImagingStudy.referrer"/>
      <short value="Referring physician"/>
      <definition value="The requesting/referring physician."/>
      <alias value="ReferringPhysiciansName"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.referrer"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.cause"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO].participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0090)+(0008,0096)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.interpreter">
      <path value="ImagingStudy.interpreter"/>
      <short value="Who interpreted images"/>
      <definition
                  value="Who read the study and interpreted the images or other content."/>
      <alias value="Name of Physician(s) Reading Study"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.interpreter"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.witness"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1060)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.endpoint">
      <path value="ImagingStudy.endpoint"/>
      <short value="Study access endpoint"/>
      <definition
                  value="The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType."/>
      <comment
               value="Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer."/>
      <requirements
                    value="Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.endpoint"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Endpoint"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Not supported"/>
      </mapping>
    </element>
    <element id="ImagingStudy.numberOfSeries">
      <path value="ImagingStudy.numberOfSeries"/>
      <short value="Number of Study Related Series"/>
      <definition
                  value="Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present."/>
      <alias value="NumberOfStudyRelatedSeries"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.numberOfSeries"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=OBSSER, moodCode=EVN].repeatNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,1206)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.numberOfInstances">
      <path value="ImagingStudy.numberOfInstances"/>
      <short value="Number of Study Related Instances"/>
      <definition
                  value="Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present."/>
      <alias value="NumberOfStudyRelatedInstances"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.numberOfInstances"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,1208)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.procedureReference">
      <path value="ImagingStudy.procedureReference"/>
      <short value="The performed Procedure reference"/>
      <definition value="The procedure which this ImagingStudy was part of."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.procedureReference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.partOf"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1032)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.procedureCode">
      <path value="ImagingStudy.procedureCode"/>
      <short value="The performed procedure code"/>
      <definition value="The code for the performed procedure type."/>
      <alias value="ProcedureCodeSequence"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.procedureCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingProcedureCode"/>
        </extension>
        <strength value="extensible"/>
        <description value="The performed procedure type."/>
        <valueSet value="http://www.rsna.org/RadLex_Playbook.aspx"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1032)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.location">
      <path value="ImagingStudy.location"/>
      <short value="Where ImagingStudy occurred"/>
      <definition
                  value="The principal physical location where the ImagingStudy was performed."/>
      <requirements
                    value="Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.location"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.where[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="EVN.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=LOC].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1040) | (0040,0243)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.reasonCode">
      <path value="ImagingStudy.reasonCode"/>
      <short value="Why the study was requested"/>
      <definition
                  value="Description of clinical condition indicating why the ImagingStudy was requested."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.reasonCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingReason"/>
        </extension>
        <strength value="example"/>
        <description value="The reason for the study."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/procedure-reason"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0040,1002)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.reasonReference">
      <path value="ImagingStudy.reasonReference"/>
      <short value="Why was study performed"/>
      <definition
                  value="Indicates another resource whose existence justifies this Study."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.reasonReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonReference"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="EVN.4 or by domain"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=RSON].target"/>
      </mapping>
    </element>
    <element id="ImagingStudy.note">
      <path value="ImagingStudy.note"/>
      <short value="User-defined comments"/>
      <definition
                  value="Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.note"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unknown"/>
      </mapping>
    </element>
    <element id="ImagingStudy.description">
      <path value="ImagingStudy.description"/>
      <short value="Institution-generated description"/>
      <definition
                  value="The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed."/>
      <alias value="StudyDescription"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,1030)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series">
      <path value="ImagingStudy.series"/>
      <short value="Each study has one or more series of instances"/>
      <definition
                  value="Each study has one or more series of images or other content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=OBSSER, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.id">
      <path value="ImagingStudy.series.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.extension">
      <path value="ImagingStudy.series.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.modifierExtension">
      <path value="ImagingStudy.series.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.uid">
      <path value="ImagingStudy.series.uid"/>
      <short value="DICOM Series Instance UID for the series"/>
      <definition value="The DICOM Series Instance UID for the series."/>
      <comment
               value="See [DICOM PS3.3 C.7.3](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.3.html)."/>
      <requirements value="DICOM Series Instance UID."/>
      <alias value="SeriesInstanceUID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.uid"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <example>
        <label value="General"/>
        <valueId
                 value="2.16.124.113543.6003.2588828330.45298.17418.2723805630"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,000E)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.number">
      <path value="ImagingStudy.series.number"/>
      <short value="Numeric identifier of this series"/>
      <definition
                  value="The numeric identifier of this series in the study."/>
      <alias value="SeriesNumber"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.number"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <example>
        <label value="General"/>
        <valueUnsignedInt value="3"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[type=COMP, source[classCode=COMPOSITION, moodCode=EVN]].sequenceNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,0011)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.modality">
      <path value="ImagingStudy.series.modality"/>
      <short value="The modality of the instances in the series"/>
      <definition value="The modality of this series sequence."/>
      <alias value="Modality"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.modality"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingModality"/>
        </extension>
        <strength value="extensible"/>
        <description value="Type of acquired data in the instance."/>
        <valueSet
                  value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0060)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.description">
      <path value="ImagingStudy.series.description"/>
      <short value="A short human readable summary of the series"/>
      <definition value="A description of the series."/>
      <alias value="SeriesDescription"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <example>
        <label value="General"/>
        <valueString value="CT Surview 180"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,103E)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.numberOfInstances">
      <path value="ImagingStudy.series.numberOfInstances"/>
      <short value="Number of Series Related Instances"/>
      <definition
                  value="Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present."/>
      <alias value="NumberOfSeriesRelatedInstances"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.numberOfInstances"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,1209)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.endpoint">
      <path value="ImagingStudy.series.endpoint"/>
      <short value="Series access endpoint"/>
      <definition
                  value="The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType."/>
      <comment
               value="Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances."/>
      <requirements
                    value="Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.endpoint"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Endpoint"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Not supported"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.bodySite">
      <path value="ImagingStudy.series.bodySite"/>
      <short value="Body part examined"/>
      <definition
                  value="The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality."/>
      <alias value="BodyPartExamined"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.bodySite"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing anatomical locations. May include laterality."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0018,0015)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.laterality">
      <path value="ImagingStudy.series.laterality"/>
      <short value="Body part laterality"/>
      <definition
                  value="The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.laterality"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Laterality"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing body site laterality (left, right, etc.)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/bodysite-laterality"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,0060)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.specimen">
      <path value="ImagingStudy.series.specimen"/>
      <short value="Specimen imaged"/>
      <definition
                  value="The specimen imaged, e.g., for whole slide imaging of a biopsy."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Specimen"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Role[classCode=SPEC]"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0040,0551) + (0040,0562)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.started">
      <path value="ImagingStudy.series.started"/>
      <short value="When the series started"/>
      <definition value="The date and time the series was started."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.started"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0021) + (0008,0031)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer">
      <path value="ImagingStudy.series.performer"/>
      <short value="Who performed the series"/>
      <definition
                  value="Indicates who or what performed the series and how they were involved."/>
      <comment
               value="If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images."/>
      <requirements
                    value="The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers."/>
      <alias value="PerformingPhysicianName"/>
      <alias value="OperatorName"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map
             value="(0008, 1050) | (0008, 1052) | (0008, 1070) | (0008, 1072)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.id">
      <path value="ImagingStudy.series.performer.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.extension">
      <path value="ImagingStudy.series.performer.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.modifierExtension">
      <path value="ImagingStudy.series.performer.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.function">
      <path value="ImagingStudy.series.performer.function"/>
      <short value="Type of performance"/>
      <definition
                  value="Distinguishes the type of involvement of the performer in the series."/>
      <requirements
                    value="Allows disambiguation of the types of involvement of different performers."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.performer.function"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="EventPerformerFunction"/>
        </extension>
        <strength value="extensible"/>
        <description value="The type of involvement of the performer."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/series-performer-function"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF].role"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.performer.actor">
      <path value="ImagingStudy.series.performer.actor"/>
      <short value="Who performed the series"/>
      <definition value="Indicates who or what performed the series."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.performer.actor"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="EVN.5 or by domain"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance">
      <path value="ImagingStudy.series.instance"/>
      <short value="A single SOP instance from the series"/>
      <definition
                  value="A single SOP instance within the series, e.g. an image, or presentation state."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImagingStudy.series.instance"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=DGIMG, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.id">
      <path value="ImagingStudy.series.instance.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.extension">
      <path value="ImagingStudy.series.instance.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.modifierExtension">
      <path value="ImagingStudy.series.instance.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.uid">
      <path value="ImagingStudy.series.instance.uid"/>
      <short value="DICOM SOP Instance UID"/>
      <definition
                  value="The DICOM SOP Instance UID for this image or other DICOM content."/>
      <comment
               value="See  [DICOM PS3.3 C.12.1](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.12.html#sect_C.12.1)."/>
      <requirements value="DICOM SOP Instance UID."/>
      <alias value="SOPInstanceUID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.uid"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <example>
        <label value="General"/>
        <valueId
                 value="2.16.124.113543.6003.189642796.63084.16748.2599092903"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0018)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.sopClass">
      <path value="ImagingStudy.series.instance.sopClass"/>
      <short value="DICOM class type"/>
      <definition value="DICOM instance  type."/>
      <alias value="SOPClassUID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.sopClass"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="sopClass"/>
        </extension>
        <strength value="extensible"/>
        <description value="The sopClass for the instance."/>
        <valueSet
                  value="http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP]. source[classCode=OBS, moodCode=EVN, code=&quot;sop class&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0008,0016)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.number">
      <path value="ImagingStudy.series.instance.number"/>
      <short value="The number of this instance in the series"/>
      <definition value="The number of instance in the series."/>
      <alias value="InstanceNumber"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.number"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <example>
        <label value="General"/>
        <valueUnsignedInt value="1"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP, source[classCode=OBSSER, moodCode=EVN]].sequenceNumber"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map value="(0020,0013)"/>
      </mapping>
    </element>
    <element id="ImagingStudy.series.instance.title">
      <path value="ImagingStudy.series.instance.title"/>
      <short value="Description of instance"/>
      <definition value="The description of the instance."/>
      <comment
               value="Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImagingStudy.series.instance.title"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".title"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <map
             value="(0008,0008) | (0007,0080) | (0040,A043) + (0008,0104) | (0042,0010)"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="ImagingStudy.id">
      <path value="ImagingStudy.id"/>
      <short value="A logical id of the resource SHALL be provided."/>
      <definition
                  value="A logical id of the resource SHALL be provided. It may be the `id` associated with the resource as persisted in a FHIR server.  If the resource is not stored in a FHIR server, the Subscriber requesting the context change SHOULD use a mechanism to generate the `id` such that it will be globally unique (e.g., a [UUID](https://en.wikipedia.org/wiki/Universally_unique_identifier)).  When a [FHIR resource]-close event including this image study is requested, the Subscriber requesting the context be closed SHALL use the same ImagingStudy resource `id` which was provided in the [FHIR resource]-open event (see also [FHIRcast ImagingStudy for Close Events](StructureDefinition-fhircast-imaging-study-close.html))."/>
      <min value="1"/>
    </element>
    <element id="ImagingStudy.identifier">
      <path value="ImagingStudy.identifier"/>
      <short
             value="At least one business identifier of the ImagingStudy SHALL be provided in a [FHIR resource]-open request (see this event's detailed description for more information)."/>
      <definition
                  value="The Study Instance UID SHALL be included as a business identifier if it is known.  In FHIR, the Study Instance UID of an ImagingStudy is stored in the `identifier` array using the identifier system of `urn:dicom:uid` and prefixing the UID value with `urn:oid:`.

The accession number of the order which triggered the image procedure to be performed SHALL be included as a business identifier if it is known.  The accession number is provided using the “ACSN” identifier type."/>
      <min value="1"/>
    </element>
    <element id="ImagingStudy.status">
      <path value="ImagingStudy.status"/>
      <short
             value="Status of the ImagingStudy, note this may not be known and hence have a value of `unknown`; however, `status` is included since it is required by the FHIR standard"/>
    </element>
    <element id="ImagingStudy.subject">
      <path value="ImagingStudy.subject"/>
      <short
             value="Reference to the Patient resource associated with the ImagingStudy (see detailed description if the image study's subject is not a patient)"/>
      <definition
                  value="A reference to the FHIR Patient resource describing the patient whose imaging study is currently in context.  A patient SHALL be present if there is a patient associated with the study.  Note there are rare cases in which the ImagingStudy.subject references a resource which is not a patient; for example a calibration study.  A reference to the related non-Patient subject of the study SHALL be present in the ImagingStudy resource as it is required by the FHIR specification but is not required to be present in the [FHIR resource]-open event's context.  For example, a reference to a Device resource could be provided as the subject (note, if no FHIR Device FHIR resource instance is available it is allowed to provide only a `display` value in the `reference`) but not provided in the FHIRcast event's `context` array."/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-patient-open"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
    </element>
  </differential>
</StructureDefinition>