CH ELM (R4)
1.16.0 - ci-build Switzerland flag

CH ELM (R4), published by Federal Office of Public Health FOPH. This guide is not an authorized publication; it is the continuous build for version 1.16.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/ch-elm/ and changes regularly. See the Directory of published versions

Resource Profile: DocumentReference for sending the report

Official URL: http://fhir.ch/ig/ch-elm/StructureDefinition/PublishDocumentReference Version: 1.16.0
Active as of 2026-10-22 Computable Name: PublishDocumentReference

Copyright/Legal: CC0-1.0

A profile on the DocumentReference resource with publication constraints:

  • must be status current
  • must have an identifier
  • uses attachment.url to carry the document as a contained resource
  • validation according to http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-document

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.Slices for contained 1..* Resource Contained, inline Resources
Slice: Unordered, Open by profile:$this

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
DocumentReference.Slices for contained.contained:document This element must be supported. 1..1 ChElmDocument Only some of the constraints on the root of this type profile have been applied to this element in the snapshot. Check the type profile directly as well CH ELM Document: Laboratory Report
DocumentReference.identifier This element is included in summaries. 1..1 Identifier Other identifiers for the document
DocumentReference.status This element is a modifier element. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
Required Pattern: current (extensions allowed)
DocumentReference.date This element must be supported. This element is included in summaries. 0..1 instant When this document reference was created
DocumentReference.relatesTo This element must be supported. This element is included in summaries. 0..* BackboneElement Relationships to other documents
DocumentReference.relatesTo.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.relatesTo.code This element is included in summaries. 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
DocumentReference.relatesTo.target This element is included in summaries. 1..1 Reference(DocumentReference) Target of the relationship
DocumentReference.securityLabel This element must be supported. This element is included in summaries. 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
DocumentReference.content This element is included in summaries. 1..1 BackboneElement Document referenced
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element is included in summaries. C 1..1 Attachment Where to access the document
Constraints: ch-elm-resolveableurl
DocumentReference.content.attachment.language This element must be supported. This element is included in summaries. 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
DocumentReference.content.attachment.url This element is included in summaries. 1..1 url The document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
DocumentReference.content.attachment.creation This element must be supported. This element is included in summaries. 0..1 dateTime Date attachment was first created

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
DocumentReference.securityLabel Base extensible SecurityLabels 📍4.0.1 FHIR Std.
DocumentReference.content.​attachment.language Base preferred Common Languages 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ch-elm-resolveableurl error DocumentReference.content.attachment Must resolve to the contained bundle. url.exists() and url.resolve()
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.Slices for contained 1..* Resource Contained, inline Resources
Slice: Unordered, Open by profile:$this
Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
DocumentReference.Slices for contained.contained:document This element must be supported. 1..1 ChElmDocument CH ELM Document: Laboratory Report
DocumentReference.modifierExtension 0..0 Extension
DocumentReference.identifier 1..1 Identifier Other identifiers for the document
DocumentReference.docStatus 0..0 preliminary | final | amended | entered-in-error
DocumentReference.date This element must be supported. 0..1 instant When this document reference was created
DocumentReference.relatesTo This element must be supported. 0..* BackboneElement Relationships to other documents
DocumentReference.securityLabel This element must be supported. 0..* CodeableConcept Document security-tags
DocumentReference.content 1..1 BackboneElement Document referenced
DocumentReference.content.attachment C 1..1 Attachment Where to access the document
Constraints: ch-elm-resolveableurl
DocumentReference.content.attachment.language This element must be supported. 0..1 code Human language of the content (BCP-47)
DocumentReference.content.attachment.url 1..1 url The document is referenced by this url, contained in the DocumentReference
DocumentReference.content.attachment.creation This element must be supported. 0..1 dateTime Date attachment was first created

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
ch-elm-resolveableurl error DocumentReference.content.attachment Must resolve to the contained bundle. url.exists() and url.resolve()
NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.id This element is included in summaries. 0..1 id Logical id of this artifact
DocumentReference.meta This element is included in summaries. 0..1 Meta Metadata about the resource
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
DocumentReference.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
DocumentReference.Slices for contained 1..* Resource Contained, inline Resources
Slice: Unordered, Open by profile:$this

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
DocumentReference.Slices for contained.contained:document This element must be supported. 1..1 ChElmDocument Only some of the constraints on the root of this type profile have been applied to this element in the snapshot. Check the type profile directly as well CH ELM Document: Laboratory Report
DocumentReference.extension 0..* Extension Additional content defined by implementations
DocumentReference.masterIdentifier This element is included in summaries. 0..1 Identifier Master Version Specific Identifier
DocumentReference.identifier This element is included in summaries. 1..1 Identifier Other identifiers for the document
DocumentReference.status This element is a modifier element. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
Required Pattern: current (extensions allowed)
DocumentReference.type This element is included in summaries. 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.
DocumentReference.category This element is included in summaries. 0..* CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
DocumentReference.subject This element is included in summaries. 0..1 Reference(Patient | Practitioner | Group | Device) Who/what is the subject of the document
DocumentReference.date This element must be supported. This element is included in summaries. 0..1 instant When this document reference was created
DocumentReference.author This element is included in summaries. 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
DocumentReference.authenticator 0..1 Reference(Practitioner | PractitionerRole | Organization) Who/what authenticated the document
DocumentReference.custodian 0..1 Reference(Organization) Organization which maintains the document
DocumentReference.relatesTo This element must be supported. This element is included in summaries. 0..* BackboneElement Relationships to other documents
DocumentReference.relatesTo.id 0..1 string Unique id for inter-element referencing
DocumentReference.relatesTo.extension 0..* Extension Additional content defined by implementations
DocumentReference.relatesTo.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.relatesTo.code This element is included in summaries. 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
DocumentReference.relatesTo.target This element is included in summaries. 1..1 Reference(DocumentReference) Target of the relationship
DocumentReference.description This element is included in summaries. 0..1 string Human-readable description
DocumentReference.securityLabel This element must be supported. This element is included in summaries. 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
DocumentReference.content This element is included in summaries. 1..1 BackboneElement Document referenced
DocumentReference.content.id 0..1 string Unique id for inter-element referencing
DocumentReference.content.extension 0..* Extension Additional content defined by implementations
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element is included in summaries. C 1..1 Attachment Where to access the document
Constraints: ch-elm-resolveableurl
DocumentReference.content.attachment.id 0..1 string Unique id for inter-element referencing
DocumentReference.content.attachment.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
DocumentReference.content.attachment.contentType This element is included in summaries. 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
Example General: text/plain; charset=UTF-8, image/png
DocumentReference.content.attachment.language This element must be supported. This element is included in summaries. 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
DocumentReference.content.attachment.data 0..1 base64Binary Data inline, base64ed
DocumentReference.content.attachment.url This element is included in summaries. 1..1 url The document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
DocumentReference.content.attachment.size This element is included in summaries. 0..1 unsignedInt Number of bytes of content (if url provided)
DocumentReference.content.attachment.hash This element is included in summaries. 0..1 base64Binary Hash of the data (sha-1, base64ed)
DocumentReference.content.attachment.title This element is included in summaries. 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
DocumentReference.content.attachment.creation This element must be supported. This element is included in summaries. 0..1 dateTime Date attachment was first created
DocumentReference.content.format This element is included in summaries. 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
DocumentReference.context This element is included in summaries. 0..1 BackboneElement Clinical context of document
DocumentReference.context.id 0..1 string Unique id for inter-element referencing
DocumentReference.context.extension 0..* Extension Additional content defined by implementations
DocumentReference.context.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.context.encounter 0..* Reference(Encounter | EpisodeOfCare) Context of the document content
DocumentReference.context.event 0..* CodeableConcept Main clinical acts documented
Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
DocumentReference.context.period This element is included in summaries. 0..1 Period Time of service that is being documented
DocumentReference.context.facilityType 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
DocumentReference.context.practiceSetting 0..1 CodeableConcept Additional details about where the content was created (e.g. clinical specialty)
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
DocumentReference.context.sourcePatientInfo 0..1 Reference(Patient) Patient demographics from source
DocumentReference.context.related 0..* Reference(Resource) Related identifiers or resources

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.type Base preferred Document Type Value Set 📍4.0.1 FHIR Std.
DocumentReference.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
DocumentReference.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
DocumentReference.securityLabel Base extensible SecurityLabels 📍4.0.1 FHIR Std.
DocumentReference.content.​attachment.contentType Base required MimeType 📍4.0.1 FHIR Std.
DocumentReference.content.​attachment.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DocumentReference.content.​format Base preferred DocumentReference Format Code Set 📍4.0.1 FHIR Std.
DocumentReference.context.​event Base example v3 Code System ActCode 📍3.0.0 THO v7.4
DocumentReference.context.​facilityType Base example Facility Type Code Value Set 📍4.0.1 FHIR Std.
DocumentReference.context.​practiceSetting Base example Practice Setting Code Value Set 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ch-elm-resolveableurl error DocumentReference.content.attachment Must resolve to the contained bundle. url.exists() and url.resolve()
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from DocumentReference

Summary

Mandatory: 4 elements
Must-Support: 6 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DocumentReference.contained

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.Slices for contained 1..* Resource Contained, inline Resources
Slice: Unordered, Open by profile:$this

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
DocumentReference.Slices for contained.contained:document This element must be supported. 1..1 ChElmDocument Only some of the constraints on the root of this type profile have been applied to this element in the snapshot. Check the type profile directly as well CH ELM Document: Laboratory Report
DocumentReference.identifier This element is included in summaries. 1..1 Identifier Other identifiers for the document
DocumentReference.status This element is a modifier element. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
Required Pattern: current (extensions allowed)
DocumentReference.date This element must be supported. This element is included in summaries. 0..1 instant When this document reference was created
DocumentReference.relatesTo This element must be supported. This element is included in summaries. 0..* BackboneElement Relationships to other documents
DocumentReference.relatesTo.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.relatesTo.code This element is included in summaries. 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
DocumentReference.relatesTo.target This element is included in summaries. 1..1 Reference(DocumentReference) Target of the relationship
DocumentReference.securityLabel This element must be supported. This element is included in summaries. 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
DocumentReference.content This element is included in summaries. 1..1 BackboneElement Document referenced
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element is included in summaries. C 1..1 Attachment Where to access the document
Constraints: ch-elm-resolveableurl
DocumentReference.content.attachment.language This element must be supported. This element is included in summaries. 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
DocumentReference.content.attachment.url This element is included in summaries. 1..1 url The document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
DocumentReference.content.attachment.creation This element must be supported. This element is included in summaries. 0..1 dateTime Date attachment was first created

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
DocumentReference.securityLabel Base extensible SecurityLabels 📍4.0.1 FHIR Std.
DocumentReference.content.​attachment.language Base preferred Common Languages 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ch-elm-resolveableurl error DocumentReference.content.attachment Must resolve to the contained bundle. url.exists() and url.resolve()
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.Slices for contained 1..* Resource Contained, inline Resources
Slice: Unordered, Open by profile:$this
Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
DocumentReference.Slices for contained.contained:document This element must be supported. 1..1 ChElmDocument CH ELM Document: Laboratory Report
DocumentReference.modifierExtension 0..0 Extension
DocumentReference.identifier 1..1 Identifier Other identifiers for the document
DocumentReference.status 1..1 code current | superseded | entered-in-error
Required Pattern: current (extensions allowed)
DocumentReference.docStatus 0..0 preliminary | final | amended | entered-in-error
DocumentReference.date This element must be supported. 0..1 instant When this document reference was created
DocumentReference.relatesTo This element must be supported. 0..* BackboneElement Relationships to other documents
DocumentReference.securityLabel This element must be supported. 0..* CodeableConcept Document security-tags
DocumentReference.content 1..1 BackboneElement Document referenced
DocumentReference.content.attachment C 1..1 Attachment Where to access the document
Constraints: ch-elm-resolveableurl
DocumentReference.content.attachment.language This element must be supported. 0..1 code Human language of the content (BCP-47)
DocumentReference.content.attachment.url 1..1 url The document is referenced by this url, contained in the DocumentReference
DocumentReference.content.attachment.creation This element must be supported. 0..1 dateTime Date attachment was first created

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
ch-elm-resolveableurl error DocumentReference.content.attachment Must resolve to the contained bundle. url.exists() and url.resolve()

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.id This element is included in summaries. 0..1 id Logical id of this artifact
DocumentReference.meta This element is included in summaries. 0..1 Meta Metadata about the resource
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
DocumentReference.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
DocumentReference.Slices for contained 1..* Resource Contained, inline Resources
Slice: Unordered, Open by profile:$this

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
DocumentReference.Slices for contained.contained:document This element must be supported. 1..1 ChElmDocument Only some of the constraints on the root of this type profile have been applied to this element in the snapshot. Check the type profile directly as well CH ELM Document: Laboratory Report
DocumentReference.extension 0..* Extension Additional content defined by implementations
DocumentReference.masterIdentifier This element is included in summaries. 0..1 Identifier Master Version Specific Identifier
DocumentReference.identifier This element is included in summaries. 1..1 Identifier Other identifiers for the document
DocumentReference.status This element is a modifier element. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
Required Pattern: current (extensions allowed)
DocumentReference.type This element is included in summaries. 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.
DocumentReference.category This element is included in summaries. 0..* CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
DocumentReference.subject This element is included in summaries. 0..1 Reference(Patient | Practitioner | Group | Device) Who/what is the subject of the document
DocumentReference.date This element must be supported. This element is included in summaries. 0..1 instant When this document reference was created
DocumentReference.author This element is included in summaries. 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
DocumentReference.authenticator 0..1 Reference(Practitioner | PractitionerRole | Organization) Who/what authenticated the document
DocumentReference.custodian 0..1 Reference(Organization) Organization which maintains the document
DocumentReference.relatesTo This element must be supported. This element is included in summaries. 0..* BackboneElement Relationships to other documents
DocumentReference.relatesTo.id 0..1 string Unique id for inter-element referencing
DocumentReference.relatesTo.extension 0..* Extension Additional content defined by implementations
DocumentReference.relatesTo.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.relatesTo.code This element is included in summaries. 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
DocumentReference.relatesTo.target This element is included in summaries. 1..1 Reference(DocumentReference) Target of the relationship
DocumentReference.description This element is included in summaries. 0..1 string Human-readable description
DocumentReference.securityLabel This element must be supported. This element is included in summaries. 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
DocumentReference.content This element is included in summaries. 1..1 BackboneElement Document referenced
DocumentReference.content.id 0..1 string Unique id for inter-element referencing
DocumentReference.content.extension 0..* Extension Additional content defined by implementations
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element is included in summaries. C 1..1 Attachment Where to access the document
Constraints: ch-elm-resolveableurl
DocumentReference.content.attachment.id 0..1 string Unique id for inter-element referencing
DocumentReference.content.attachment.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
DocumentReference.content.attachment.contentType This element is included in summaries. 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
Example General: text/plain; charset=UTF-8, image/png
DocumentReference.content.attachment.language This element must be supported. This element is included in summaries. 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
DocumentReference.content.attachment.data 0..1 base64Binary Data inline, base64ed
DocumentReference.content.attachment.url This element is included in summaries. 1..1 url The document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
DocumentReference.content.attachment.size This element is included in summaries. 0..1 unsignedInt Number of bytes of content (if url provided)
DocumentReference.content.attachment.hash This element is included in summaries. 0..1 base64Binary Hash of the data (sha-1, base64ed)
DocumentReference.content.attachment.title This element is included in summaries. 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
DocumentReference.content.attachment.creation This element must be supported. This element is included in summaries. 0..1 dateTime Date attachment was first created
DocumentReference.content.format This element is included in summaries. 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
DocumentReference.context This element is included in summaries. 0..1 BackboneElement Clinical context of document
DocumentReference.context.id 0..1 string Unique id for inter-element referencing
DocumentReference.context.extension 0..* Extension Additional content defined by implementations
DocumentReference.context.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.context.encounter 0..* Reference(Encounter | EpisodeOfCare) Context of the document content
DocumentReference.context.event 0..* CodeableConcept Main clinical acts documented
Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
DocumentReference.context.period This element is included in summaries. 0..1 Period Time of service that is being documented
DocumentReference.context.facilityType 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
DocumentReference.context.practiceSetting 0..1 CodeableConcept Additional details about where the content was created (e.g. clinical specialty)
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
DocumentReference.context.sourcePatientInfo 0..1 Reference(Patient) Patient demographics from source
DocumentReference.context.related 0..* Reference(Resource) Related identifiers or resources

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.type Base preferred Document Type Value Set 📍4.0.1 FHIR Std.
DocumentReference.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
DocumentReference.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
DocumentReference.securityLabel Base extensible SecurityLabels 📍4.0.1 FHIR Std.
DocumentReference.content.​attachment.contentType Base required MimeType 📍4.0.1 FHIR Std.
DocumentReference.content.​attachment.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DocumentReference.content.​format Base preferred DocumentReference Format Code Set 📍4.0.1 FHIR Std.
DocumentReference.context.​event Base example v3 Code System ActCode 📍3.0.0 THO v7.4
DocumentReference.context.​facilityType Base example Facility Type Code Value Set 📍4.0.1 FHIR Std.
DocumentReference.context.​practiceSetting Base example Practice Setting Code Value Set 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ch-elm-resolveableurl error DocumentReference.content.attachment Must resolve to the contained bundle. url.exists() and url.resolve()
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from DocumentReference

Summary

Mandatory: 4 elements
Must-Support: 6 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DocumentReference.contained

 

Other representations of profile: CSV, Excel, Schematron