Introduction

A set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

Scope and Usage

In scope of the eHealth infrastructure, the Composition is used primarily for internal use when assembling resources into documents during publication to national document sharing.

When retrieving documents from national document sharing, these are represented as Clinical Document Architecture (CDA) XML documents. When choosing to transform the content to FHIR resources, the resulting Composition is the FHIR resource tying the other, resulting resources together as a document.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
authorOrganization		0..*	Reference(ehealth-organization) {b, c}	Organization that authored the Composition URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Document Type (required)
category		0..1	CodeableConcept	Categorization of Composition Binding: Document Class (required)
subject		1..1	Reference(Resource)	Who and/or what the composition is about
encounter		0..1	Reference(Encounter) {b, c}	Context of the Composition
author		1..*	Reference(ehealth-practitioner | ehealth-device | ehealth-patient | ehealth-relatedperson)	Who and/or what authored the composition
attester
party		0..1	Reference(ehealth-patient | ehealth-practitioner | ehealth-organization)	Who attested the composition
custodian		0..1	Reference(ehealth-organization) {b, c}	Organization which maintains the composition
relatesTo
Slices for target[x]		1..1	Identifier, Reference(Composition)	Target of the relationship Slice: Unordered, Open by type:$this
target[x]:targetIdentifier		0..1	Identifier	Target of the relationship
target[x]:targetReference		0..1	Reference(ehealth-composition)	Target of the relationship
event
code		0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: Event Type Codes (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	required	DocumentType http://ehealth.sundhed.dk/vs/document-type from this IG
Composition.category	required	DocumentClass http://ehealth.sundhed.dk/vs/document-class from this IG
Composition.event.code	required	EventTypeCodes http://ehealth.sundhed.dk/vs/event-type-codes from this IG

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
authorOrganization		0..*	Reference(ehealth-organization) {b, c}	Organization that authored the Composition URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Document Type (required)
category	Σ	0..1	CodeableConcept	Categorization of Composition Binding: Document Class (required)
subject	Σ	1..1	Reference(Resource)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter) {b, c}	Context of the Composition
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..*	Reference(ehealth-practitioner | ehealth-device | ehealth-patient | ehealth-relatedperson)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
custodian	Σ	0..1	Reference(ehealth-organization) {b, c}	Organization which maintains the composition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	required	DocumentType http://ehealth.sundhed.dk/vs/document-type from this IG
Composition.category	required	DocumentClass http://ehealth.sundhed.dk/vs/document-class from this IG

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
authorOrganization		0..*	Reference(ehealth-organization) {b, c}	Organization that authored the Composition URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Version-independent identifier for the Composition
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Document Type (required)
category	Σ	0..1	CodeableConcept	Categorization of Composition Binding: Document Class (required)
subject	Σ	1..1	Reference(Resource)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter) {b, c}	Context of the Composition
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..*	Reference(ehealth-practitioner | ehealth-device | ehealth-patient | ehealth-relatedperson)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(ehealth-patient | ehealth-practitioner | ehealth-organization)	Who attested the composition
custodian	Σ	0..1	Reference(ehealth-organization) {b, c}	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
Slices for target[x]		1..1		Target of the relationship Slice: Unordered, Closed by type:$this
targetIdentifier			Identifier
targetReference			Reference(Composition)
target[x]:targetIdentifier		0..1	Identifier	Target of the relationship
target[x]:targetReference		0..1	Reference(ehealth-composition)	Target of the relationship
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: Event Type Codes (required)
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
section	C	0..*	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	required	DocumentType http://ehealth.sundhed.dk/vs/document-type from this IG
Composition.category	required	DocumentClass http://ehealth.sundhed.dk/vs/document-class from this IG
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	required	EventTypeCodes http://ehealth.sundhed.dk/vs/event-type-codes from this IG
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

Differential View

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
authorOrganization		0..*	Reference(ehealth-organization) {b, c}	Organization that authored the Composition URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Document Type (required)
category		0..1	CodeableConcept	Categorization of Composition Binding: Document Class (required)
subject		1..1	Reference(Resource)	Who and/or what the composition is about
encounter		0..1	Reference(Encounter) {b, c}	Context of the Composition
author		1..*	Reference(ehealth-practitioner | ehealth-device | ehealth-patient | ehealth-relatedperson)	Who and/or what authored the composition
attester
party		0..1	Reference(ehealth-patient | ehealth-practitioner | ehealth-organization)	Who attested the composition
custodian		0..1	Reference(ehealth-organization) {b, c}	Organization which maintains the composition
relatesTo
Slices for target[x]		1..1	Identifier, Reference(Composition)	Target of the relationship Slice: Unordered, Open by type:$this
target[x]:targetIdentifier		0..1	Identifier	Target of the relationship
target[x]:targetReference		0..1	Reference(ehealth-composition)	Target of the relationship
event
code		0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: Event Type Codes (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	required	DocumentType http://ehealth.sundhed.dk/vs/document-type from this IG
Composition.category	required	DocumentClass http://ehealth.sundhed.dk/vs/document-class from this IG
Composition.event.code	required	EventTypeCodes http://ehealth.sundhed.dk/vs/event-type-codes from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
authorOrganization		0..*	Reference(ehealth-organization) {b, c}	Organization that authored the Composition URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Document Type (required)
category	Σ	0..1	CodeableConcept	Categorization of Composition Binding: Document Class (required)
subject	Σ	1..1	Reference(Resource)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter) {b, c}	Context of the Composition
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..*	Reference(ehealth-practitioner | ehealth-device | ehealth-patient | ehealth-relatedperson)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
custodian	Σ	0..1	Reference(ehealth-organization) {b, c}	Organization which maintains the composition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	required	DocumentType http://ehealth.sundhed.dk/vs/document-type from this IG
Composition.category	required	DocumentClass http://ehealth.sundhed.dk/vs/document-class from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
authorOrganization		0..*	Reference(ehealth-organization) {b, c}	Organization that authored the Composition URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Version-independent identifier for the Composition
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: Document Type (required)
category	Σ	0..1	CodeableConcept	Categorization of Composition Binding: Document Class (required)
subject	Σ	1..1	Reference(Resource)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter) {b, c}	Context of the Composition
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..*	Reference(ehealth-practitioner | ehealth-device | ehealth-patient | ehealth-relatedperson)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(ehealth-patient | ehealth-practitioner | ehealth-organization)	Who attested the composition
custodian	Σ	0..1	Reference(ehealth-organization) {b, c}	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
Slices for target[x]		1..1		Target of the relationship Slice: Unordered, Closed by type:$this
targetIdentifier			Identifier
targetReference			Reference(Composition)
target[x]:targetIdentifier		0..1	Identifier	Target of the relationship
target[x]:targetReference		0..1	Reference(ehealth-composition)	Target of the relationship
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: Event Type Codes (required)
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
section	C	0..*	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	required	DocumentType http://ehealth.sundhed.dk/vs/document-type from this IG
Composition.category	required	DocumentClass http://ehealth.sundhed.dk/vs/document-class from this IG
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	required	EventTypeCodes http://ehealth.sundhed.dk/vs/event-type-codes from this IG
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

This structure is derived from Composition

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• ehealth-practitioner (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-practitioner)
• ehealth-device (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-device)
• ehealth-patient (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-patient)
• ehealth-relatedperson (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-relatedperson)
• ehealth-organization (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-organization)
• ehealth-composition (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition)

Extensions

This structure refers to these extensions:

• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-composition-authorOrganization

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Composition.relatesTo.target[x]