Cross Border Data Exchange IG
1.0.0 - CI Build International flag

Cross Border Data Exchange IG, published by IEHR-Workgroup. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/InteropEHRate-project/cross-border-data-exchange/ and changes regularly. See the Directory of published versions

Resource Profile: DocumentManifestIEHR - Detailed Descriptions

Draft as of 2024-04-08

Definitions for the DocumentManifest-IEHR resource profile.

Guidance on how to interpret the contents of this table can be found here

0. DocumentManifest
2. DocumentManifest.extension
Must Supporttrue
SlicingThis element introduces a set of slices on DocumentManifest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. DocumentManifest.type
    Definition

    The code specifying the type of clinical activity that resulted in the creation of the DocumentManifest

    Control1..?
    Must Supporttrue
    6. DocumentManifest.subject
    Definition

    The person or group the documents referenced in the manifest are about

    Control1..?
    TypeReference(Patient-IEHR, Practitioner (IPS), Group, Device)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    8. DocumentManifest.created
    Definition

    The date when the manifest was created. The attribute does not change when the manifest is modified, the modification date ist saved in DocumentManifest.meta.lastUpdated instead.

    Control1..?
    Must Supporttrue
    10. DocumentManifest.author
    Definition

    The author of the manifest. This does not necessarily have to be the author of the referenced documents.

    Comments

    The exact constrains on this attribute are still under consideration

    Control1..?
    TypeReference(Practitioner (IPS), PractitionerRole (IPS), Organization (IPS), Device, Patient-IEHR, RelatedPerson)
    12. DocumentManifest.content
    Definition

    The documents that are part of this manifest

    TypeReference(DocumentReference-IEHR)
    14. DocumentManifest.related
    Definition

    Items that are in some way related to the DocumentManifest. They are either represented with an Identifier or with a Reference to another resource

    Comments

    The exact constrains on this attribute are still under consideration

    16. DocumentManifest.related.ref
    Definition

    Reference to another resource, that is in some way related to the DocumentManifest

    Comments

    The exact constrains on this attribute are still under consideration

    Guidance on how to interpret the contents of this table can be found here

    0. DocumentManifest
    Definition

    A collection of documents compiled for a purpose together with metadata that applies to the collection.

    ShortA list that defines a set of documents
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. DocumentManifest.implicitRules
    Definition

    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.

    ShortA set of rules under which this content was created
    Comments

    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.

    Control0..1
    Typeuri
    Is Modifiertrue because 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
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. DocumentManifest.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on DocumentManifest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. DocumentManifest.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      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.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. DocumentManifest.status
      Definition

      The status of this document manifest.

      Shortcurrent | superseded | entered-in-error
      Comments

      This element is labeled as a modifier because the status contains the codes that mark the manifest as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from DocumentReferenceStatushttp://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1)

      The status of the document reference.

      Typecode
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. DocumentManifest.type
      Definition

      The code specifying the type of clinical activity that resulted in the creation of the DocumentManifest


      The code specifying the type of clinical activity that resulted in placing the associated content into the DocumentManifest.

      ShortKind of document set
      Comments

      Specifies the kind of this set of documents (e.g. Patient Summary, Discharge Summary, Prescription, etc.). The type of a set of documents may be the same as one of the documents in it - especially if there is only one - but it may be wider.

      Control10..1
      BindingFor example codes, see v3 Code System ActCodehttp://terminology.hl7.org/ValueSet/v3-ActCode
      (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

      The activity that caused the DocumentManifest to be created.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. DocumentManifest.subject
      Definition

      The person or group the documents referenced in the manifest are about


      Who or what the set of documents is about. The documents can be about a person, (patient or healthcare practitioner), a device (i.e. machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure). If the documents cross more than one subject, then more than one subject is allowed here (unusual use case).

      ShortThe subject of the set of documents
      Control10..1
      TypeReference(Patient-IEHR, Practitioner (IPS), Group, Device, Patient, Practitioner)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. DocumentManifest.created
      Definition

      The date when the manifest was created. The attribute does not change when the manifest is modified, the modification date ist saved in DocumentManifest.meta.lastUpdated instead.


      When the document manifest was created for submission to the server (not necessarily the same thing as the actual resource last modified time, since it may be modified, replicated, etc.).

      ShortWhen this document manifest created
      Comments

      Creation time is used for tracking, organizing versions and searching. This is the creation time of the document set, not the documents on which it is based.

      Control10..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. DocumentManifest.author
      Definition

      The author of the manifest. This does not necessarily have to be the author of the referenced documents.


      Identifies who is the author of the manifest. Manifest author is not necessarly the author of the references included.

      ShortWho and/or what authored the DocumentManifest
      Comments

      The exact constrains on this attribute are still under consideration


      Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).

      Control10..*
      TypeReference(Practitioner (IPS), PractitionerRole (IPS), Organization (IPS), Device, Patient-IEHR, RelatedPerson, Practitioner, PractitionerRole, Organization, Patient)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. DocumentManifest.content
      Definition

      The documents that are part of this manifest


      The list of Resources that consist of the parts of this manifest.

      ShortItems in manifest
      Comments

      When used for XDS the intended focus of the DocumentManifest is for the reference to target to be a set of DocumentReference Resources. The reference is to "Any" to support EN 13606 usage, where an extract is DocumentManifest that references List and Composition resources.

      Control1..*
      TypeReference(DocumentReference-IEHR, Resource)
      Is Modifierfalse
      Summarytrue
      Requirements

      Any Resources are allowed to be grouped in a Manifest. The manifest brings context to the group.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. DocumentManifest.related
      Definition

      Items that are in some way related to the DocumentManifest. They are either represented with an Identifier or with a Reference to another resource


      Related identifiers or resources associated with the DocumentManifest.

      ShortRelated things
      Comments

      The exact constrains on this attribute are still under consideration


      May be identifiers or resources that caused the DocumentManifest to be created.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. DocumentManifest.related.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      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.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. DocumentManifest.related.ref
      Definition

      Reference to another resource, that is in some way related to the DocumentManifest


      Related Resource to this DocumentManifest. For example, Order, ServiceRequest, Procedure, EligibilityRequest, etc.

      ShortRelated Resource
      Comments

      The exact constrains on this attribute are still under consideration


      If both identifier and ref elements are present they shall refer to the same thing.

      Control0..1
      TypeReference(Resource)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. DocumentManifest
      Definition

      A collection of documents compiled for a purpose together with metadata that applies to the collection.

      ShortA list that defines a set of documents
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. DocumentManifest.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. DocumentManifest.meta
      Definition

      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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. DocumentManifest.implicitRules
      Definition

      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.

      ShortA set of rules under which this content was created
      Comments

      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.

      Control0..1
      Typeuri
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. DocumentManifest.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. DocumentManifest.text
      Definition

      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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. DocumentManifest.contained
      Definition

      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.

      ShortContained, inline Resources
      Comments

      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.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. DocumentManifest.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on DocumentManifest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. DocumentManifest.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        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.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. DocumentManifest.masterIdentifier
        Definition

        A single identifier that uniquely identifies this manifest. Principally used to refer to the manifest in non-FHIR contexts.

        ShortUnique Identifier for the set of documents
        Control0..1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. DocumentManifest.identifier
        Definition

        Other identifiers associated with the document manifest, including version independent identifiers.

        ShortOther identifiers for the manifest
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. DocumentManifest.status
        Definition

        The status of this document manifest.

        Shortcurrent | superseded | entered-in-error
        Comments

        This element is labeled as a modifier because the status contains the codes that mark the manifest as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from DocumentReferenceStatus
        (required to http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1)

        The status of the document reference.

        Typecode
        Is Modifiertrue because 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
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. DocumentManifest.type
        Definition

        The code specifying the type of clinical activity that resulted in the creation of the DocumentManifest

        ShortKind of document set
        Comments

        Specifies the kind of this set of documents (e.g. Patient Summary, Discharge Summary, Prescription, etc.). The type of a set of documents may be the same as one of the documents in it - especially if there is only one - but it may be wider.

        Control1..1
        BindingFor example codes, see v3 Code System ActCode
        (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

        The activity that caused the DocumentManifest to be created.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. DocumentManifest.subject
        Definition

        The person or group the documents referenced in the manifest are about

        ShortThe subject of the set of documents
        Control1..1
        TypeReference(Patient-IEHR, Practitioner (IPS), Group, Device)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. DocumentManifest.created
        Definition

        The date when the manifest was created. The attribute does not change when the manifest is modified, the modification date ist saved in DocumentManifest.meta.lastUpdated instead.

        ShortWhen this document manifest created
        Comments

        Creation time is used for tracking, organizing versions and searching. This is the creation time of the document set, not the documents on which it is based.

        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. DocumentManifest.author
        Definition

        The author of the manifest. This does not necessarily have to be the author of the referenced documents.

        ShortWho and/or what authored the DocumentManifest
        Comments

        The exact constrains on this attribute are still under consideration

        Control1..*
        TypeReference(Practitioner (IPS), PractitionerRole (IPS), Organization (IPS), Device, Patient-IEHR, RelatedPerson)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. DocumentManifest.recipient
        Definition

        A patient, practitioner, or organization for which this set of documents is intended.

        ShortIntended to get notified about this set of documents
        Comments

        How the recipient receives the document set or is notified of it is up to the implementation. This element is just a statement of intent. If the recipient is a person, and it is not known whether the person is a patient or a practitioner, RelatedPerson would be the default choice.

        Control0..*
        TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. DocumentManifest.source
        Definition

        Identifies the source system, application, or software that produced the document manifest.

        ShortThe source system/application/software
        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. DocumentManifest.description
        Definition

        Human-readable description of the source document. This is sometimes known as the "title".

        ShortHuman-readable description (title)
        Comments

        What the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a "consultation" or "progress note").

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Helps humans to assess whether the document is of interest.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. DocumentManifest.content
        Definition

        The documents that are part of this manifest

        ShortItems in manifest
        Comments

        When used for XDS the intended focus of the DocumentManifest is for the reference to target to be a set of DocumentReference Resources. The reference is to "Any" to support EN 13606 usage, where an extract is DocumentManifest that references List and Composition resources.

        Control1..*
        TypeReference(DocumentReference-IEHR)
        Is Modifierfalse
        Summarytrue
        Requirements

        Any Resources are allowed to be grouped in a Manifest. The manifest brings context to the group.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. DocumentManifest.related
        Definition

        Items that are in some way related to the DocumentManifest. They are either represented with an Identifier or with a Reference to another resource

        ShortRelated things
        Comments

        The exact constrains on this attribute are still under consideration

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. DocumentManifest.related.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        44. DocumentManifest.related.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        46. DocumentManifest.related.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        48. DocumentManifest.related.identifier
        Definition

        Related identifier to this DocumentManifest. For example, Order numbers, accession numbers, XDW workflow numbers.

        ShortIdentifiers of things that are related
        Comments

        If both identifier and ref elements are present they shall refer to the same thing.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. DocumentManifest.related.ref
        Definition

        Reference to another resource, that is in some way related to the DocumentManifest

        ShortRelated Resource
        Comments

        The exact constrains on this attribute are still under consideration

        Control0..1
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))