HL7 Europe Patient Summary
0.0.1-ci - ci-build 150

HL7 Europe Patient Summary, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/eps/ and changes regularly. See the Directory of published versions

Resource Profile: CompositionEuEps - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the composition-eu-eps resource profile.

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

0. Composition
Definition

Patient Summary composition. A composition is 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.


A set of healthcare-related information that is assembled together into a single logical package 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. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

ShortPatient Summary compositionA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

Control0..*
Is Modifierfalse
Impose ProfileThis profile also requires that the instance also conform this additional profile:
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. Composition.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. Composition.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
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 Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Composition.extension:version
    Slice Nameversion
    Definition

    This cross-version extension represents Composition.version from http://hl7.org/fhir/StructureDefinition/Composition|5.0.0 for use in FHIR R4.

    ShortBusiness version
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
    Is Modifierfalse
    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())
    ele-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. Composition.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())
    10. Composition.identifier
    Definition

    A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

    ShortPS business identifierVersion-independent identifier for the Composition
    Comments

    Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Composition.status
    Definition

    The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

    ShortPS statuspreliminary | final | amended | entered-in-error
    Comments

    If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

    Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

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

    The workflow/clinical status of the composition.

    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
    Requirements

    Need to be able to mark interim, amended, or withdrawn compositions or documents.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Composition.type
    Definition

    Specifies that this composition refer to a Patient Summary


    Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

    ShortKind of composition ("Patient Summary")Kind of composition (LOINC if possible)
    Comments

    For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

    Control1..1
    BindingThe codes SHOULD be taken from FHIRDocumentTypeCodeshttp://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1)

    Type of a composition.

    TypeCodeableConcept(Codeable Concept (IPS))
    Is Modifierfalse
    Summarytrue
    Requirements

    Key metadata element describing the composition, used in searching/filtering.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Composition.subject
    Definition

    Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the PS the subject is always the patient.


    Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

    ShortWho and/or what the composition is about
    Comments

    For clinical documents, this is usually the patient.

    Control10..1
    TypeReference(Patient (EPS), Resource)
    Is Modifierfalse
    Summarytrue
    Requirements

    Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Composition.date
    Definition

    The composition editing time, when the composition was last logically changed by the author.

    ShortPS dateComposition editing time
    Comments

    The Last Modified Date on the composition may be after the date of the document was attested without being changed.

    Control1..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.


    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

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

    Identifies who is responsible for the information in the Patient Summary, not necessarily who typed it in.


    Identifies who is responsible for the information in the composition, not necessarily who typed it in.

    ShortWho and/or what authored the Patient SummaryWho and/or what authored the composition
    Control1..*
    TypeReference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Patient (EU core), RelatedPerson, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
    Is Modifierfalse
    Summarytrue
    Requirements

    Identifies who is responsible for the content.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Composition.title
    Definition

    Official human-readable label for the composition.

    For this document should be "Patient Summary" or any equivalent translation


    Official human-readable label for the composition.

    ShortPatient SummaryHuman Readable name/title
    Comments

    For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

    Control1..1
    Typestring
    Is Modifierfalse
    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. Composition.custodian
    Definition

    Identifies the organization that is responsible for ongoing maintenance of the Patient Summary, and ensures that it remains available for access by other parties.


    Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

    ShortCustodian of the Patient SummaryOrganization which maintains the composition
    Comments

    This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

    Control0..1
    TypeReference(Organization (EU core), Organization)
    Is Modifierfalse
    Summarytrue
    Requirements

    Identifies where to go to find the current version, where to report issues, etc.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Composition.section
    Definition

    The root of the sections that make up the IPS composition.


    The root of the sections that make up the composition.

    ShortSections composing the IPSComposition is broken into sections
    Control30..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
    SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ code
    • 28. Composition.section.extension
      Definition

      An Extension


      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.

      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
      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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 30. Composition.section.extension:section-note
        Slice Namesection-note
        Definition

        Additional notes that apply to the section (but not to specific resource).

        ShortAdditional notes that apply to the section (but not to specific resource).
        Comments

        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

        Control0..*
        TypeExtension(Note) (Extension Type: Annotation)
        Is Modifierfalse
        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())
        ele-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())
        32. Composition.section.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())
        34. Composition.section.title
        Definition

        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

        ShortLabel for section (e.g. for ToC)
        Comments

        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

        Alternate Namesheader, label, caption
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Composition.section.code
        Definition

        A code identifying the kind of content contained within the section. This must be consistent with the section title.

        ShortClassification of section (recommended)
        Comments

        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

        Control10..1
        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
        (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

        Classification of a section of a composition/document.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

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

        A human-readable narrative that contains the attested content of the section, 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.

        ShortText summary of the section, for human interpretation
        Comments

        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

        Control10..1
        This element is affected by the following invariants: cmp-1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Composition.section.section
        Definition

        A nested sub-section within this section.

        ShortNested Section
        Comments

        Nested sections are primarily used to help human readers navigate to particular portions of the document.

        Control0..0*
        This element is affected by the following invariants: cmp-1
        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Composition.section:sectionProblems
        Slice NamesectionProblems
        Definition

        Active Problems Section description


        The root of the sections that make up the composition.

        ShortActive ProblemsComposition is broken into sections
        Control10..1*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
        cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        44. Composition.section:sectionProblems.extension:section-note
        Slice Namesection-note
        Definition

        Additional notes that apply to the section (but not to specific resource).

        ShortAdditional notes that apply to the section (but not to specific resource).
        Comments

        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

        Control0..*
        TypeExtension(Note) (Extension Type: Annotation)
        Is Modifierfalse
        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())
        ele-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. Composition.section:sectionProblems.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. Composition.section:sectionProblems.title
        Definition

        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

        ShortLabel for section (e.g. for ToC)
        Comments

        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

        Alternate Namesheader, label, caption
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Composition.section:sectionProblems.code
        Definition

        A code identifying the kind of content contained within the section. This must be consistent with the section title.

        ShortClassification of section (recommended)
        Comments

        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

        Control10..1
        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
        (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

        Classification of a section of a composition/document.

        TypeCodeableConcept(Codeable Concept (IPS))
        Is Modifierfalse
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "11450-4"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Composition.section:sectionProblems.text
        Definition

        A human-readable narrative that contains the attested content of the section, 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.

        ShortText summary of the section, for human interpretation
        Comments

        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

        Control10..1
        This element is affected by the following invariants: cmp-1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Composition.section:sectionProblems.entry
        Definition

        DESC Problems


        A reference to the actual resource from which the narrative in the section is derived.

        ShortActive ProblemsA reference to data that supports this section
        Comments

        If there are no entries in the list, an emptyReason SHOULD be provided.

        Control0..*
        This element is affected by the following invariants: cmp-2
        TypeReference(Condition, DocumentReference, Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ resolve()
        • 56. Composition.section:sectionProblems.entry:problem
          Slice Nameproblem
          Definition

          It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.


          A reference to the actual resource from which the narrative in the section is derived.

          ShortClinical problems or conditions currently being monitored for the patient.A reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..1*
          This element is affected by the following invariants: cmp-2
          TypeReference(Condition (EPS), Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. Composition.section:sectionProblems.section
          Definition

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..0*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Composition.section:sectionAllergies
          Slice NamesectionAllergies
          Definition

          Allergy section description


          The root of the sections that make up the composition.

          ShortAllergies and Other Adverse ReactionsComposition is broken into sections
          Control10..1*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          62. Composition.section:sectionAllergies.extension:section-note
          Slice Namesection-note
          Definition

          Additional notes that apply to the section (but not to specific resource).

          ShortAdditional notes that apply to the section (but not to specific resource).
          Comments

          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

          Control0..*
          TypeExtension(Note) (Extension Type: Annotation)
          Is Modifierfalse
          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())
          ele-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())
          64. Composition.section:sectionAllergies.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())
          66. Composition.section:sectionAllergies.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. Composition.section:sectionAllergies.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control10..1
          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

          Classification of a section of a composition/document.

          TypeCodeableConcept(Codeable Concept (IPS))
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "48765-2"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Composition.section:sectionAllergies.text
          Definition

          A human-readable narrative that contains the attested content of the section, 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.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control10..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. Composition.section:sectionAllergies.entry
          Definition

          allergyOrIntolerance


          A reference to the actual resource from which the narrative in the section is derived.

          ShortallergyOrIntoleranceA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(AllergyIntolerance, DocumentReference, Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ resolve()
          • 74. Composition.section:sectionAllergies.entry:allergyOrIntolerance
            Slice NameallergyOrIntolerance
            Definition

            Description


            A reference to the actual resource from which the narrative in the section is derived.

            ShortRelevant allergies or intolerances for that patient.A reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..1*
            This element is affected by the following invariants: cmp-2
            TypeReference(Allergy Intolerance (EU core) [WIP], Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. Composition.section:sectionAllergies.section
            Definition

            A nested sub-section within this section.

            ShortNested Section
            Comments

            Nested sections are primarily used to help human readers navigate to particular portions of the document.

            Control0..0*
            This element is affected by the following invariants: cmp-1
            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. Composition.section:sectionMedications
            Slice NamesectionMedications
            Definition

            The medication summary section contains a description of the patient's medications as part of the patient summary


            The root of the sections that make up the composition.

            ShortMedication SummaryComposition is broken into sections
            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            80. Composition.section:sectionMedications.extension:section-note
            Slice Namesection-note
            Definition

            Additional notes that apply to the section (but not to specific resource).

            ShortAdditional notes that apply to the section (but not to specific resource).
            Comments

            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

            Control0..*
            TypeExtension(Note) (Extension Type: Annotation)
            Is Modifierfalse
            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())
            ele-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())
            82. Composition.section:sectionMedications.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())
            84. Composition.section:sectionMedications.title
            Definition

            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

            ShortLabel for section (e.g. for ToC)
            Comments

            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

            Alternate Namesheader, label, caption
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. Composition.section:sectionMedications.code
            Definition

            A code identifying the kind of content contained within the section. This must be consistent with the section title.

            ShortClassification of section (recommended)
            Comments

            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

            Control10..1
            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

            Classification of a section of a composition/document.

            TypeCodeableConcept(Codeable Concept (IPS))
            Is Modifierfalse
            Summaryfalse
            Requirements

            Provides computable standardized labels to topics within the document.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "10160-0"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. Composition.section:sectionMedications.text
            Definition

            A human-readable narrative that contains the attested content of the section, 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.

            ShortText summary of the section, for human interpretation
            Comments

            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

            Control10..1
            This element is affected by the following invariants: cmp-1
            TypeNarrative
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Composition.section:sectionMedications.entry
            Definition

            medicationStatementOrRequest


            A reference to the actual resource from which the narrative in the section is derived.

            ShortmedicationStatementOrRequestA reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..*
            This element is affected by the following invariants: cmp-2
            TypeReference(Medication Statement (EPS), MedicationRequest (EPS), MedicationAdministration (EPS), MedicationDispense (EPS), Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ resolve()
            • 92. Composition.section:sectionMedications.entry:medicationStatementOrRequest
              Slice NamemedicationStatementOrRequest
              Definition

              A reference to the actual resource from which the narrative in the section is derived.

              ShortA reference to data that supports this section
              Comments

              If there are no entries in the list, an emptyReason SHOULD be provided.

              Control0..1*
              This element is affected by the following invariants: cmp-2
              TypeReference(Medication Statement (EPS), MedicationRequest (EPS), Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. Composition.section:sectionMedications.section
              Definition

              A nested sub-section within this section.

              ShortNested Section
              Comments

              Nested sections are primarily used to help human readers navigate to particular portions of the document.

              Control0..0*
              This element is affected by the following invariants: cmp-1
              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              96. Composition.section:sectionImmunizations
              Slice NamesectionImmunizations
              Definition

              The immunizations section contains a narrative description of the immunizations administered to the patient in the past. It includes entries for medication administration as described in related profiles


              The root of the sections that make up the composition.

              ShortImmunizationsComposition is broken into sections
              Control0..1*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              98. Composition.section:sectionImmunizations.extension:section-note
              Slice Namesection-note
              Definition

              Additional notes that apply to the section (but not to specific resource).

              ShortAdditional notes that apply to the section (but not to specific resource).
              Comments

              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

              Control0..*
              TypeExtension(Note) (Extension Type: Annotation)
              Is Modifierfalse
              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())
              ele-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())
              100. Composition.section:sectionImmunizations.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())
              102. Composition.section:sectionImmunizations.title
              Definition

              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

              ShortLabel for section (e.g. for ToC)
              Comments

              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

              Alternate Namesheader, label, caption
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Composition.section:sectionImmunizations.code
              Definition

              A code identifying the kind of content contained within the section. This must be consistent with the section title.

              ShortClassification of section (recommended)
              Comments

              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

              Control10..1
              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
              (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

              Classification of a section of a composition/document.

              TypeCodeableConcept(Codeable Concept (IPS))
              Is Modifierfalse
              Summaryfalse
              Requirements

              Provides computable standardized labels to topics within the document.

              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "11369-6"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Composition.section:sectionImmunizations.text
              Definition

              A human-readable narrative that contains the attested content of the section, 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.

              ShortText summary of the section, for human interpretation
              Comments

              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

              Control10..1
              This element is affected by the following invariants: cmp-1
              TypeNarrative
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. Composition.section:sectionImmunizations.entry
              Definition

              It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.


              A reference to the actual resource from which the narrative in the section is derived.

              ShortPatient's immunization status and pertinent history.A reference to data that supports this section
              Comments

              If there are no entries in the list, an emptyReason SHOULD be provided.

              Control0..*
              This element is affected by the following invariants: cmp-2
              TypeReference(Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ resolve()
              • 110. Composition.section:sectionImmunizations.entry:immunization
                Slice Nameimmunization
                Definition

                DESCR Immunizartion


                A reference to the actual resource from which the narrative in the section is derived.

                ShortSHORT ImmunizationA reference to data that supports this section
                Comments

                If there are no entries in the list, an emptyReason SHOULD be provided.

                Control0..1*
                This element is affected by the following invariants: cmp-2
                TypeReference(Immunization (EPS), Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                112. Composition.section:sectionImmunizations.section
                Definition

                A nested sub-section within this section.

                ShortNested Section
                Comments

                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                Control0..0*
                This element is affected by the following invariants: cmp-1
                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                114. Composition.section:sectionResults
                Slice NamesectionResults
                Definition

                The root of the sections that make up the composition.

                ShortCoded ResultsComposition is broken into sections
                Control0..1*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                116. Composition.section:sectionResults.extension:section-note
                Slice Namesection-note
                Definition

                Additional notes that apply to the section (but not to specific resource).

                ShortAdditional notes that apply to the section (but not to specific resource).
                Comments

                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                Control0..*
                TypeExtension(Note) (Extension Type: Annotation)
                Is Modifierfalse
                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())
                ele-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())
                118. Composition.section:sectionResults.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())
                120. Composition.section:sectionResults.title
                Definition

                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                ShortLabel for section (e.g. for ToC)
                Comments

                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                Control10..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                Alternate Namesheader, label, caption
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. Composition.section:sectionResults.code
                Definition

                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                ShortClassification of section (recommended)
                Comments

                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                Control10..1
                BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. Composition.section:sectionResults.text
                Definition

                A human-readable narrative that contains the attested content of the section, 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.

                ShortText summary of the section, for human interpretation
                Comments

                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                Control10..1
                This element is affected by the following invariants: cmp-1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                126. Composition.section:sectionResults.section
                Definition

                A nested sub-section within this section.

                ShortNested Section
                Comments

                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                Control0..0*
                This element is affected by the following invariants: cmp-1
                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                128. Composition.section:sectionProceduresHx
                Slice NamesectionProceduresHx
                Definition

                DESC Procedures


                The root of the sections that make up the composition.

                ShortHistory of ProceduresComposition is broken into sections
                Control0..1*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                130. Composition.section:sectionProceduresHx.extension:section-note
                Slice Namesection-note
                Definition

                Additional notes that apply to the section (but not to specific resource).

                ShortAdditional notes that apply to the section (but not to specific resource).
                Comments

                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                Control0..*
                TypeExtension(Note) (Extension Type: Annotation)
                Is Modifierfalse
                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())
                ele-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())
                132. Composition.section:sectionProceduresHx.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())
                134. Composition.section:sectionProceduresHx.title
                Definition

                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                ShortLabel for section (e.g. for ToC)
                Comments

                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                Control10..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                Alternate Namesheader, label, caption
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. Composition.section:sectionProceduresHx.code
                Definition

                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                ShortClassification of section (recommended)
                Comments

                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                Control10..1
                BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                Classification of a section of a composition/document.

                TypeCodeableConcept(Codeable Concept (IPS))
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "47519-4"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. Composition.section:sectionProceduresHx.text
                Definition

                A human-readable narrative that contains the attested content of the section, 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.

                ShortText summary of the section, for human interpretation
                Comments

                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                Control10..1
                This element is affected by the following invariants: cmp-1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                140. Composition.section:sectionProceduresHx.entry
                Definition

                DESC Procedures


                A reference to the actual resource from which the narrative in the section is derived.

                ShortPatient past procedures pertinent to the scope of this document.A reference to data that supports this section
                Comments

                If there are no entries in the list, an emptyReason SHOULD be provided.

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Procedure, DocumentReference, Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ resolve()
                • 142. Composition.section:sectionProceduresHx.entry:procedure
                  Slice Nameprocedure
                  Definition

                  It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.


                  A reference to the actual resource from which the narrative in the section is derived.

                  ShortClinical problems or conditions currently being monitored for the patient.A reference to data that supports this section
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..1*
                  This element is affected by the following invariants: cmp-2
                  TypeReference(Procedure (EPS), Resource)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. Composition.section:sectionProceduresHx.section
                  Definition

                  A nested sub-section within this section.

                  ShortNested Section
                  Comments

                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                  Control0..0*
                  This element is affected by the following invariants: cmp-1
                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  146. Composition.section:sectionMedicalDevices
                  Slice NamesectionMedicalDevices
                  Definition

                  The medical devices section contains a narrative description of the medical devices used by the patient in the past. It includes entries for device use as described in related profiles


                  The root of the sections that make up the composition.

                  ShortMedical DevicesComposition is broken into sections
                  Control0..1*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                  148. Composition.section:sectionMedicalDevices.extension:section-note
                  Slice Namesection-note
                  Definition

                  Additional notes that apply to the section (but not to specific resource).

                  ShortAdditional notes that apply to the section (but not to specific resource).
                  Comments

                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                  Control0..*
                  TypeExtension(Note) (Extension Type: Annotation)
                  Is Modifierfalse
                  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())
                  ele-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())
                  150. Composition.section:sectionMedicalDevices.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())
                  152. Composition.section:sectionMedicalDevices.title
                  Definition

                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                  ShortLabel for section (e.g. for ToC)
                  Comments

                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                  Control10..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                  Alternate Namesheader, label, caption
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  154. Composition.section:sectionMedicalDevices.code
                  Definition

                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                  ShortClassification of section (recommended)
                  Comments

                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                  Control10..1
                  BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                  Classification of a section of a composition/document.

                  TypeCodeableConcept(Codeable Concept (IPS))
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Provides computable standardized labels to topics within the document.

                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "46264-8"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  156. Composition.section:sectionMedicalDevices.text
                  Definition

                  A human-readable narrative that contains the attested content of the section, 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.

                  ShortText summary of the section, for human interpretation
                  Comments

                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                  Control10..1
                  This element is affected by the following invariants: cmp-1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  158. Composition.section:sectionMedicalDevices.entry
                  Definition

                  Med devices Description


                  A reference to the actual resource from which the narrative in the section is derived.

                  ShortMed Device shortA reference to data that supports this section
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..*
                  This element is affected by the following invariants: cmp-2
                  TypeReference(Resource)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ resolve()
                  • 160. Composition.section:sectionMedicalDevices.entry:deviceStatement
                    Slice NamedeviceStatement
                    Definition

                    DESCR deviceStatement


                    A reference to the actual resource from which the narrative in the section is derived.

                    ShortSHORT deviceStatementA reference to data that supports this section
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..1*
                    This element is affected by the following invariants: cmp-2
                    TypeReference(DeviceUseStatement (EPS), Resource)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    162. Composition.section:sectionMedicalDevices.section
                    Definition

                    A nested sub-section within this section.

                    ShortNested Section
                    Comments

                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                    Control0..0*
                    This element is affected by the following invariants: cmp-1
                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    164. Composition.section:sectionAdvanceDirectives
                    Slice NamesectionAdvanceDirectives
                    Definition

                    The advance directives section contains a narrative description of patient's advance directive.


                    The root of the sections that make up the composition.

                    ShortAdvance Directives SectionComposition is broken into sections
                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    166. Composition.section:sectionAdvanceDirectives.extension:section-note
                    Slice Namesection-note
                    Definition

                    Additional notes that apply to the section (but not to specific resource).

                    ShortAdditional notes that apply to the section (but not to specific resource).
                    Comments

                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                    Control0..*
                    TypeExtension(Note) (Extension Type: Annotation)
                    Is Modifierfalse
                    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())
                    ele-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())
                    168. Composition.section:sectionAdvanceDirectives.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())
                    170. Composition.section:sectionAdvanceDirectives.title
                    Definition

                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                    ShortLabel for section (e.g. for ToC)
                    Comments

                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                    Alternate Namesheader, label, caption
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    172. Composition.section:sectionAdvanceDirectives.code
                    Definition

                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                    ShortClassification of section (recommended)
                    Comments

                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                    Control10..1
                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                    Classification of a section of a composition/document.

                    TypeCodeableConcept(Codeable Concept (IPS))
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Provides computable standardized labels to topics within the document.

                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "42348-3"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    174. Composition.section:sectionAdvanceDirectives.text
                    Definition

                    A human-readable narrative that contains the attested content of the section, 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.

                    ShortText summary of the section, for human interpretation
                    Comments

                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                    Control10..1
                    This element is affected by the following invariants: cmp-1
                    TypeNarrative
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    176. Composition.section:sectionAdvanceDirectives.entry
                    Definition

                    A reference to the actual resource from which the narrative in the section is derived.

                    ShortA reference to data that supports this section
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..*
                    This element is affected by the following invariants: cmp-2
                    TypeReference(Consent (Advance Directives EPS), DocumentReference, Resource)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    178. Composition.section:sectionAdvanceDirectives.section
                    Definition

                    A nested sub-section within this section.

                    ShortNested Section
                    Comments

                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                    Control0..0*
                    This element is affected by the following invariants: cmp-1
                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    180. Composition.section:sectionAlerts
                    Slice NamesectionAlerts
                    Definition

                    The root of the sections that make up the composition.

                    ShortComposition is broken into sections
                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    182. Composition.section:sectionAlerts.extension:section-note
                    Slice Namesection-note
                    Definition

                    Additional notes that apply to the section (but not to specific resource).

                    ShortAdditional notes that apply to the section (but not to specific resource).
                    Comments

                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                    Control0..*
                    TypeExtension(Note) (Extension Type: Annotation)
                    Is Modifierfalse
                    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())
                    ele-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())
                    184. Composition.section:sectionAlerts.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())
                    186. Composition.section:sectionAlerts.title
                    Definition

                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                    ShortLabel for section (e.g. for ToC)
                    Comments

                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                    Alternate Namesheader, label, caption
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    188. Composition.section:sectionAlerts.code
                    Definition

                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                    ShortClassification of section (recommended)
                    Comments

                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                    Control10..1
                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                    Classification of a section of a composition/document.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Provides computable standardized labels to topics within the document.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    190. Composition.section:sectionAlerts.text
                    Definition

                    A human-readable narrative that contains the attested content of the section, 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.

                    ShortText summary of the section, for human interpretation
                    Comments

                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                    Control10..1
                    This element is affected by the following invariants: cmp-1
                    TypeNarrative
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    192. Composition.section:sectionAlerts.section
                    Definition

                    A nested sub-section within this section.

                    ShortNested Section
                    Comments

                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                    Control0..0*
                    This element is affected by the following invariants: cmp-1
                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    194. Composition.section:sectionFunctionalStatus
                    Slice NamesectionFunctionalStatus
                    Definition

                    The functional status section contains a narrative description of the patient's functional status. It includes entries for functional status as described in related profiles


                    The root of the sections that make up the composition.

                    ShortFunctional StatusComposition is broken into sections
                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    196. Composition.section:sectionFunctionalStatus.extension:section-note
                    Slice Namesection-note
                    Definition

                    Additional notes that apply to the section (but not to specific resource).

                    ShortAdditional notes that apply to the section (but not to specific resource).
                    Comments

                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                    Control0..*
                    TypeExtension(Note) (Extension Type: Annotation)
                    Is Modifierfalse
                    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())
                    ele-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())
                    198. Composition.section:sectionFunctionalStatus.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())
                    200. Composition.section:sectionFunctionalStatus.title
                    Definition

                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                    ShortLabel for section (e.g. for ToC)
                    Comments

                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                    Alternate Namesheader, label, caption
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    202. Composition.section:sectionFunctionalStatus.code
                    Definition

                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                    ShortClassification of section (recommended)
                    Comments

                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                    Control10..1
                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                    Classification of a section of a composition/document.

                    TypeCodeableConcept(Codeable Concept (IPS))
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Provides computable standardized labels to topics within the document.

                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "47420-5"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    204. Composition.section:sectionFunctionalStatus.text
                    Definition

                    A human-readable narrative that contains the attested content of the section, 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.

                    ShortText summary of the section, for human interpretation
                    Comments

                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                    Control10..1
                    This element is affected by the following invariants: cmp-1
                    TypeNarrative
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    206. Composition.section:sectionFunctionalStatus.entry
                    Definition

                    Functional Status Description


                    A reference to the actual resource from which the narrative in the section is derived.

                    ShortFunctional Status shortA reference to data that supports this section
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..*
                    This element is affected by the following invariants: cmp-2
                    TypeReference(Resource)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ resolve()
                    • 208. Composition.section:sectionFunctionalStatus.entry:functionalStatus
                      Slice NamefunctionalStatus
                      Definition

                      DESCR functionalStatus


                      A reference to the actual resource from which the narrative in the section is derived.

                      ShortSHORT functionalStatusA reference to data that supports this section
                      Comments

                      If there are no entries in the list, an emptyReason SHOULD be provided.

                      Control0..1*
                      This element is affected by the following invariants: cmp-2
                      TypeReference(Condition (EPS), Resource)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      210. Composition.section:sectionFunctionalStatus.section
                      Definition

                      A nested sub-section within this section.

                      ShortNested Section
                      Comments

                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                      Control0..0*
                      This element is affected by the following invariants: cmp-1
                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      212. Composition.section:sectionPastProblems
                      Slice NamesectionPastProblems
                      Definition

                      The past problems section contains a narrative description of the patient's past problems. It includes entries for problems as described in related profiles


                      The root of the sections that make up the composition.

                      ShortPast ProblemsComposition is broken into sections
                      Control0..1*
                      TypeBackboneElement
                      Is Modifierfalse
                      Summaryfalse
                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                      214. Composition.section:sectionPastProblems.extension:section-note
                      Slice Namesection-note
                      Definition

                      Additional notes that apply to the section (but not to specific resource).

                      ShortAdditional notes that apply to the section (but not to specific resource).
                      Comments

                      This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                      Control0..*
                      TypeExtension(Note) (Extension Type: Annotation)
                      Is Modifierfalse
                      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())
                      ele-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())
                      216. Composition.section:sectionPastProblems.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())
                      218. Composition.section:sectionPastProblems.title
                      Definition

                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                      ShortLabel for section (e.g. for ToC)
                      Comments

                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                      Control10..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Requirements

                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                      Alternate Namesheader, label, caption
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      220. Composition.section:sectionPastProblems.code
                      Definition

                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                      ShortClassification of section (recommended)
                      Comments

                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                      Control10..1
                      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                      Classification of a section of a composition/document.

                      TypeCodeableConcept(Codeable Concept (IPS))
                      Is Modifierfalse
                      Summaryfalse
                      Requirements

                      Provides computable standardized labels to topics within the document.

                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "8716-3"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      222. Composition.section:sectionPastProblems.text
                      Definition

                      A human-readable narrative that contains the attested content of the section, 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.

                      ShortText summary of the section, for human interpretation
                      Comments

                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                      Control10..1
                      This element is affected by the following invariants: cmp-1
                      TypeNarrative
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      224. Composition.section:sectionPastProblems.entry
                      Definition

                      Past Problems Description


                      A reference to the actual resource from which the narrative in the section is derived.

                      ShortPast Problems shortA reference to data that supports this section
                      Comments

                      If there are no entries in the list, an emptyReason SHOULD be provided.

                      Control0..*
                      This element is affected by the following invariants: cmp-2
                      TypeReference(Resource)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ resolve()
                      • 226. Composition.section:sectionPastProblems.entry:pastProblem
                        Slice NamepastProblem
                        Definition

                        DESCR pastProblem


                        A reference to the actual resource from which the narrative in the section is derived.

                        ShortSHORT pastProblemA reference to data that supports this section
                        Comments

                        If there are no entries in the list, an emptyReason SHOULD be provided.

                        Control0..1*
                        This element is affected by the following invariants: cmp-2
                        TypeReference(Condition (EPS), Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        228. Composition.section:sectionPastProblems.section
                        Definition

                        A nested sub-section within this section.

                        ShortNested Section
                        Comments

                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                        Control0..0*
                        This element is affected by the following invariants: cmp-1
                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        230. Composition.section:sectionPregnancyHx
                        Slice NamesectionPregnancyHx
                        Definition

                        The pregnancy history section contains a narrative description of the patient's pregnancy history. It includes entries for pregnancy history as described in related profiles


                        The root of the sections that make up the composition.

                        ShortPregnancy HistoryComposition is broken into sections
                        Control0..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Summaryfalse
                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                        cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                        232. Composition.section:sectionPregnancyHx.extension:section-note
                        Slice Namesection-note
                        Definition

                        Additional notes that apply to the section (but not to specific resource).

                        ShortAdditional notes that apply to the section (but not to specific resource).
                        Comments

                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                        Control0..*
                        TypeExtension(Note) (Extension Type: Annotation)
                        Is Modifierfalse
                        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())
                        ele-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())
                        234. Composition.section:sectionPregnancyHx.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())
                        236. Composition.section:sectionPregnancyHx.title
                        Definition

                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                        ShortLabel for section (e.g. for ToC)
                        Comments

                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                        Control10..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Requirements

                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                        Alternate Namesheader, label, caption
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        238. Composition.section:sectionPregnancyHx.code
                        Definition

                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                        ShortClassification of section (recommended)
                        Comments

                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                        Control10..1
                        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                        Classification of a section of a composition/document.

                        TypeCodeableConcept(Codeable Concept (IPS))
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Provides computable standardized labels to topics within the document.

                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "10162-6"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        240. Composition.section:sectionPregnancyHx.text
                        Definition

                        A human-readable narrative that contains the attested content of the section, 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.

                        ShortText summary of the section, for human interpretation
                        Comments

                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                        Control10..1
                        This element is affected by the following invariants: cmp-1
                        TypeNarrative
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        242. Composition.section:sectionPregnancyHx.entry
                        Definition

                        Pregnancy History Description


                        A reference to the actual resource from which the narrative in the section is derived.

                        ShortPregnancy History shortA reference to data that supports this section
                        Comments

                        If there are no entries in the list, an emptyReason SHOULD be provided.

                        Control0..*
                        This element is affected by the following invariants: cmp-2
                        TypeReference(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • type @ resolve()
                        • 244. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
                          Slice NamepregnancyStatus
                          Definition

                          DESCR Pregnancy status


                          A reference to the actual resource from which the narrative in the section is derived.

                          ShortPregnancy statusA reference to data that supports this section
                          Comments

                          If there are no entries in the list, an emptyReason SHOULD be provided.

                          Control0..1*
                          This element is affected by the following invariants: cmp-2
                          TypeReference(Observation Pregnancy - Status (IPS), Resource)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          246. Composition.section:sectionPregnancyHx.entry:pregnancyOutcome
                          Slice NamepregnancyOutcome
                          Definition

                          DESCR Pregnancy outcome


                          A reference to the actual resource from which the narrative in the section is derived.

                          ShortPregnancy outcomeA reference to data that supports this section
                          Comments

                          If there are no entries in the list, an emptyReason SHOULD be provided.

                          Control0..1*
                          This element is affected by the following invariants: cmp-2
                          TypeReference(Observation Pregnancy - Outcome (IPS), Resource)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          248. Composition.section:sectionPregnancyHx.section
                          Definition

                          A nested sub-section within this section.

                          ShortNested Section
                          Comments

                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                          Control0..0*
                          This element is affected by the following invariants: cmp-1
                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          250. Composition.section:sectionPatientStory
                          Slice NamesectionPatientStory
                          Definition

                          The root of the sections that make up the composition.

                          ShortComposition is broken into sections
                          Control0..1*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          252. Composition.section:sectionPatientStory.extension:section-note
                          Slice Namesection-note
                          Definition

                          Additional notes that apply to the section (but not to specific resource).

                          ShortAdditional notes that apply to the section (but not to specific resource).
                          Comments

                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                          Control0..*
                          TypeExtension(Note) (Extension Type: Annotation)
                          Is Modifierfalse
                          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())
                          ele-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())
                          254. Composition.section:sectionPatientStory.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())
                          256. Composition.section:sectionPatientStory.title
                          Definition

                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                          ShortLabel for section (e.g. for ToC)
                          Comments

                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                          Alternate Namesheader, label, caption
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          258. Composition.section:sectionPatientStory.code
                          Definition

                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                          ShortClassification of section (recommended)
                          Comments

                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                          Control10..1
                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                          Classification of a section of a composition/document.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Provides computable standardized labels to topics within the document.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          260. Composition.section:sectionPatientStory.text
                          Definition

                          A human-readable narrative that contains the attested content of the section, 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.

                          ShortText summary of the section, for human interpretation
                          Comments

                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                          Control10..1
                          This element is affected by the following invariants: cmp-1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          262. Composition.section:sectionPatientStory.section
                          Definition

                          A nested sub-section within this section.

                          ShortNested Section
                          Comments

                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                          Control0..0*
                          This element is affected by the following invariants: cmp-1
                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          264. Composition.section:sectionPlanOfCare
                          Slice NamesectionPlanOfCare
                          Definition

                          The health maintenance care plan section contains a description of the expectations for wellness care including proposals, goals, and order requests for monitoring, tracking, or improving the lifetime condition of the patient with goals of educating the patient on how to reduce the modifiable risks of the patient\’s genetic, behavioral, and environmental pre-conditions and otherwise optimizing lifetime outcomes.


                          The root of the sections that make up the composition.

                          ShortHealth Maintenance Care PlanComposition is broken into sections
                          Control0..1*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          266. Composition.section:sectionPlanOfCare.extension:section-note
                          Slice Namesection-note
                          Definition

                          Additional notes that apply to the section (but not to specific resource).

                          ShortAdditional notes that apply to the section (but not to specific resource).
                          Comments

                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                          Control0..*
                          TypeExtension(Note) (Extension Type: Annotation)
                          Is Modifierfalse
                          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())
                          ele-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())
                          268. Composition.section:sectionPlanOfCare.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())
                          270. Composition.section:sectionPlanOfCare.title
                          Definition

                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                          ShortLabel for section (e.g. for ToC)
                          Comments

                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                          Alternate Namesheader, label, caption
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          272. Composition.section:sectionPlanOfCare.code
                          Definition

                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                          ShortClassification of section (recommended)
                          Comments

                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                          Control10..1
                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                          Classification of a section of a composition/document.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Provides computable standardized labels to topics within the document.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          274. Composition.section:sectionPlanOfCare.text
                          Definition

                          A human-readable narrative that contains the attested content of the section, 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.

                          ShortText summary of the section, for human interpretation
                          Comments

                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                          Control10..1
                          This element is affected by the following invariants: cmp-1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          276. Composition.section:sectionPlanOfCare.section
                          Definition

                          A nested sub-section within this section.

                          ShortNested Section
                          Comments

                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                          Control0..0*
                          This element is affected by the following invariants: cmp-1
                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          278. Composition.section:sectionSocialHistory
                          Slice NamesectionSocialHistory
                          Definition

                          The social history section contains a narrative description of the person\’s beliefs, home life, community life, work life, hobbies, and risky habits. It includes Social History Observations.


                          The root of the sections that make up the composition.

                          ShortSocial HistoryComposition is broken into sections
                          Control0..1*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          280. Composition.section:sectionSocialHistory.extension:section-note
                          Slice Namesection-note
                          Definition

                          Additional notes that apply to the section (but not to specific resource).

                          ShortAdditional notes that apply to the section (but not to specific resource).
                          Comments

                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                          Control0..*
                          TypeExtension(Note) (Extension Type: Annotation)
                          Is Modifierfalse
                          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())
                          ele-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())
                          282. Composition.section:sectionSocialHistory.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())
                          284. Composition.section:sectionSocialHistory.title
                          Definition

                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                          ShortLabel for section (e.g. for ToC)
                          Comments

                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                          Alternate Namesheader, label, caption
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          286. Composition.section:sectionSocialHistory.code
                          Definition

                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                          ShortClassification of section (recommended)
                          Comments

                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                          Control10..1
                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                          Classification of a section of a composition/document.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Provides computable standardized labels to topics within the document.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          288. Composition.section:sectionSocialHistory.text
                          Definition

                          A human-readable narrative that contains the attested content of the section, 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.

                          ShortText summary of the section, for human interpretation
                          Comments

                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                          Control10..1
                          This element is affected by the following invariants: cmp-1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          290. Composition.section:sectionSocialHistory.section
                          Definition

                          A nested sub-section within this section.

                          ShortNested Section
                          Comments

                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                          Control0..0*
                          This element is affected by the following invariants: cmp-1
                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          292. Composition.section:sectionVitalSigns
                          Slice NamesectionVitalSigns
                          Definition

                          The vital signs section contains a narrative description of the patient's vital signs. It includes entries for vital sign measurements as described in related profiles


                          The root of the sections that make up the composition.

                          ShortVital SignsComposition is broken into sections
                          Control0..1*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          294. Composition.section:sectionVitalSigns.extension:section-note
                          Slice Namesection-note
                          Definition

                          Additional notes that apply to the section (but not to specific resource).

                          ShortAdditional notes that apply to the section (but not to specific resource).
                          Comments

                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                          Control0..*
                          TypeExtension(Note) (Extension Type: Annotation)
                          Is Modifierfalse
                          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())
                          ele-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())
                          296. Composition.section:sectionVitalSigns.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())
                          298. Composition.section:sectionVitalSigns.title
                          Definition

                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                          ShortLabel for section (e.g. for ToC)
                          Comments

                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                          Alternate Namesheader, label, caption
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          300. Composition.section:sectionVitalSigns.code
                          Definition

                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                          ShortClassification of section (recommended)
                          Comments

                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                          Control10..1
                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                          Classification of a section of a composition/document.

                          TypeCodeableConcept(Codeable Concept (IPS))
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Provides computable standardized labels to topics within the document.

                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "8716-3"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          302. Composition.section:sectionVitalSigns.text
                          Definition

                          A human-readable narrative that contains the attested content of the section, 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.

                          ShortText summary of the section, for human interpretation
                          Comments

                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                          Control10..1
                          This element is affected by the following invariants: cmp-1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          304. Composition.section:sectionVitalSigns.entry
                          Definition

                          Vital Signs Description


                          A reference to the actual resource from which the narrative in the section is derived.

                          ShortVital Signs shortA reference to data that supports this section
                          Comments

                          If there are no entries in the list, an emptyReason SHOULD be provided.

                          Control0..*
                          This element is affected by the following invariants: cmp-2
                          TypeReference(Resource)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • type @ resolve()
                          • 306. Composition.section:sectionVitalSigns.entry:vitalSign
                            Slice NamevitalSign
                            Definition

                            DESCR vitalSign


                            A reference to the actual resource from which the narrative in the section is derived.

                            ShortSHORT vitalSignA reference to data that supports this section
                            Comments

                            If there are no entries in the list, an emptyReason SHOULD be provided.

                            Control0..1*
                            This element is affected by the following invariants: cmp-2
                            TypeReference(Vital Signs Profile, Resource)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            308. Composition.section:sectionVitalSigns.section
                            Definition

                            A nested sub-section within this section.

                            ShortNested Section
                            Comments

                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                            Control0..0*
                            This element is affected by the following invariants: cmp-1
                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            310. Composition.section:sectionAlert
                            Slice NamesectionAlert
                            Definition

                            Information used to warn or call to a state of preparedness. Information flagged or intended to raise awareness of a potential danger to from the subject of the IPS or to from another individual or awareness of a potential obstacle to care.


                            The root of the sections that make up the composition.

                            ShortAlerts SectionComposition is broken into sections
                            Control0..1*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            312. Composition.section:sectionAlert.extension:section-note
                            Slice Namesection-note
                            Definition

                            Additional notes that apply to the section (but not to specific resource).

                            ShortAdditional notes that apply to the section (but not to specific resource).
                            Comments

                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                            Control0..*
                            TypeExtension(Note) (Extension Type: Annotation)
                            Is Modifierfalse
                            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())
                            ele-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())
                            314. Composition.section:sectionAlert.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())
                            316. Composition.section:sectionAlert.title
                            Definition

                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                            ShortLabel for section (e.g. for ToC)
                            Comments

                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                            Control10..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Requirements

                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                            Alternate Namesheader, label, caption
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            318. Composition.section:sectionAlert.code
                            Definition

                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                            ShortClassification of section (recommended)
                            Comments

                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                            Control10..1
                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                            Classification of a section of a composition/document.

                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Provides computable standardized labels to topics within the document.

                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "104605-1"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            320. Composition.section:sectionAlert.text
                            Definition

                            A human-readable narrative that contains the attested content of the section, 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.

                            ShortText summary of the section, for human interpretation
                            Comments

                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                            Control10..1
                            This element is affected by the following invariants: cmp-1
                            TypeNarrative
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            322. Composition.section:sectionAlert.entry
                            Definition

                            Alerts


                            A reference to the actual resource from which the narrative in the section is derived.

                            ShortAlertsA reference to data that supports this section
                            Comments

                            If there are no entries in the list, an emptyReason SHOULD be provided.

                            Control0..*
                            This element is affected by the following invariants: cmp-2
                            TypeReference(Resource)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • type @ resolve()
                            • 324. Composition.section:sectionAlert.entry:flag
                              Slice Nameflag
                              Definition

                              Flags


                              A reference to the actual resource from which the narrative in the section is derived.

                              ShortFlagsA reference to data that supports this section
                              Comments

                              If there are no entries in the list, an emptyReason SHOULD be provided.

                              Control0..1*
                              This element is affected by the following invariants: cmp-2
                              TypeReference(Flag (EU core) [WIP], Resource)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              326. Composition.section:sectionAlert.section
                              Definition

                              A nested sub-section within this section.

                              ShortNested Section
                              Comments

                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                              Control0..0*
                              This element is affected by the following invariants: cmp-1
                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              328. Composition.section:sectionTravelHx
                              Slice NamesectionTravelHx
                              Definition

                              This Section describes the travel history relevant for the Patient Summary, e.g.recent travel in a region of high prevalence of a specific infectious disease like Malaria


                              The root of the sections that make up the composition.

                              ShortTravel History SectionComposition is broken into sections
                              Control0..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              330. Composition.section:sectionTravelHx.extension:section-note
                              Slice Namesection-note
                              Definition

                              Additional notes that apply to the section (but not to specific resource).

                              ShortAdditional notes that apply to the section (but not to specific resource).
                              Comments

                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                              Control0..*
                              TypeExtension(Note) (Extension Type: Annotation)
                              Is Modifierfalse
                              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())
                              ele-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())
                              332. Composition.section:sectionTravelHx.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())
                              334. Composition.section:sectionTravelHx.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShortLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              336. Composition.section:sectionTravelHx.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept(Codeable Concept (IPS))
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "10182-4"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              338. Composition.section:sectionTravelHx.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              340. Composition.section:sectionTravelHx.entry
                              Definition

                              A reference to the actual resource from which the narrative in the section is derived.

                              ShortA reference to data that supports this section
                              Comments

                              If there are no entries in the list, an emptyReason SHOULD be provided.

                              Control0..*
                              This element is affected by the following invariants: cmp-2
                              TypeReference(Observation: country visited (HDR), Resource)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              342. Composition.section:sectionTravelHx.section
                              Definition

                              A nested sub-section within this section.

                              ShortNested Section
                              Comments

                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                              Control0..0*
                              This element is affected by the following invariants: cmp-1
                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              344. Composition.section:sectionPatientHx
                              Slice NamesectionPatientHx
                              Definition

                              This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.


                              The root of the sections that make up the composition.

                              ShortPatient History SectionComposition is broken into sections
                              Control0..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              346. Composition.section:sectionPatientHx.extension:section-note
                              Slice Namesection-note
                              Definition

                              Additional notes that apply to the section (but not to specific resource).

                              ShortAdditional notes that apply to the section (but not to specific resource).
                              Comments

                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                              Control0..*
                              TypeExtension(Note) (Extension Type: Annotation)
                              Is Modifierfalse
                              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())
                              ele-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())
                              348. Composition.section:sectionPatientHx.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())
                              350. Composition.section:sectionPatientHx.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShortLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              352. Composition.section:sectionPatientHx.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept(Codeable Concept (IPS))
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "11329-0"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              354. Composition.section:sectionPatientHx.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              356. Composition.section:sectionPatientHx.section
                              Definition

                              A nested sub-section within this section.

                              ShortNested Section
                              Comments

                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                              Control0..0*
                              This element is affected by the following invariants: cmp-1
                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                              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 foundhere

                              0. Composition
                              Definition

                              Patient Summary composition. A composition is 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.

                              ShortPatient Summary composition
                              Impose ProfileThis profile also requires that the instance also conform this additional profile:
                              2. Composition.extension
                              SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 4. Composition.extension:version
                                Slice Nameversion
                                ShortBusiness version
                                Control0..1
                                TypeExtension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
                                6. Composition.identifier
                                ShortPS business identifier
                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                8. Composition.status
                                ShortPS status
                                10. Composition.type
                                Definition

                                Specifies that this composition refer to a Patient Summary

                                ShortKind of composition ("Patient Summary")
                                TypeCodeableConcept(Codeable Concept (IPS))
                                12. Composition.subject
                                Definition

                                Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the PS the subject is always the patient.

                                Control1..?
                                TypeReference(Patient (EPS))
                                14. Composition.date
                                ShortPS date
                                16. Composition.author
                                Definition

                                Identifies who is responsible for the information in the Patient Summary, not necessarily who typed it in.

                                ShortWho and/or what authored the Patient Summary
                                TypeReference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Patient (EU core), RelatedPerson)
                                18. Composition.title
                                Definition

                                Official human-readable label for the composition.

                                For this document should be "Patient Summary" or any equivalent translation

                                ShortPatient Summary
                                20. Composition.attester
                                22. Composition.attester.mode
                                ShortThe type of attestation
                                24. Composition.attester.party
                                TypeReference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Patient (EPS), RelatedPerson)
                                26. Composition.custodian
                                Definition

                                Identifies the organization that is responsible for ongoing maintenance of the Patient Summary, and ensures that it remains available for access by other parties.

                                ShortCustodian of the Patient Summary
                                TypeReference(Organization (EU core))
                                28. Composition.section
                                Definition

                                The root of the sections that make up the IPS composition.

                                ShortSections composing the IPS
                                Control3..?
                                SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ code
                                • 30. Composition.section.extension
                                  SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 32. Composition.section.extension:section-note
                                    Slice Namesection-note
                                    Definition

                                    Additional notes that apply to the section (but not to specific resource).

                                    ShortAdditional notes that apply to the section (but not to specific resource).
                                    Control0..*
                                    TypeExtension(Note) (Extension Type: Annotation)
                                    34. Composition.section.title
                                    Control1..?
                                    36. Composition.section.code
                                    Control1..?
                                    38. Composition.section.text
                                    Control1..?
                                    40. Composition.section.section
                                    Control0..0
                                    42. Composition.section:sectionProblems
                                    Slice NamesectionProblems
                                    Definition

                                    Active Problems Section description

                                    ShortActive Problems
                                    Control1..1
                                    Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                    44. Composition.section:sectionProblems.extension:section-note
                                    Slice Namesection-note
                                    Definition

                                    Additional notes that apply to the section (but not to specific resource).

                                    ShortAdditional notes that apply to the section (but not to specific resource).
                                    Control0..*
                                    TypeExtension(Note) (Extension Type: Annotation)
                                    46. Composition.section:sectionProblems.code
                                    TypeCodeableConcept(Codeable Concept (IPS))
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "11450-4"
                                      }]
                                    }
                                    48. Composition.section:sectionProblems.entry
                                    Definition

                                    DESC Problems

                                    ShortActive Problems
                                    TypeReference(Condition, DocumentReference)
                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • type @ resolve()
                                    • 50. Composition.section:sectionProblems.entry:problem
                                      Slice Nameproblem
                                      Definition

                                      It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.

                                      ShortClinical problems or conditions currently being monitored for the patient.
                                      Control0..1
                                      TypeReference(Condition (EPS))
                                      52. Composition.section:sectionAllergies
                                      Slice NamesectionAllergies
                                      Definition

                                      Allergy section description

                                      ShortAllergies and Other Adverse Reactions
                                      Control1..1
                                      Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                      54. Composition.section:sectionAllergies.extension:section-note
                                      Slice Namesection-note
                                      Definition

                                      Additional notes that apply to the section (but not to specific resource).

                                      ShortAdditional notes that apply to the section (but not to specific resource).
                                      Control0..*
                                      TypeExtension(Note) (Extension Type: Annotation)
                                      56. Composition.section:sectionAllergies.code
                                      TypeCodeableConcept(Codeable Concept (IPS))
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "48765-2"
                                        }]
                                      }
                                      58. Composition.section:sectionAllergies.entry
                                      Definition

                                      allergyOrIntolerance

                                      ShortallergyOrIntolerance
                                      TypeReference(AllergyIntolerance, DocumentReference)
                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • type @ resolve()
                                      • 60. Composition.section:sectionAllergies.entry:allergyOrIntolerance
                                        Slice NameallergyOrIntolerance
                                        Definition

                                        Description

                                        ShortRelevant allergies or intolerances for that patient.
                                        Control0..1
                                        TypeReference(Allergy Intolerance (EU core) [WIP])
                                        62. Composition.section:sectionMedications
                                        Slice NamesectionMedications
                                        Definition

                                        The medication summary section contains a description of the patient's medications as part of the patient summary

                                        ShortMedication Summary
                                        Control1..1
                                        Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                        64. Composition.section:sectionMedications.extension:section-note
                                        Slice Namesection-note
                                        Definition

                                        Additional notes that apply to the section (but not to specific resource).

                                        ShortAdditional notes that apply to the section (but not to specific resource).
                                        Control0..*
                                        TypeExtension(Note) (Extension Type: Annotation)
                                        66. Composition.section:sectionMedications.code
                                        TypeCodeableConcept(Codeable Concept (IPS))
                                        Pattern Value{
                                          "coding" : [{
                                            "system" : "http://loinc.org",
                                            "code" : "10160-0"
                                          }]
                                        }
                                        68. Composition.section:sectionMedications.entry
                                        Definition

                                        medicationStatementOrRequest

                                        ShortmedicationStatementOrRequest
                                        TypeReference(Medication Statement (EPS), MedicationRequest (EPS), MedicationAdministration (EPS), MedicationDispense (EPS))
                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • type @ resolve()
                                        • 70. Composition.section:sectionMedications.entry:medicationStatementOrRequest
                                          Slice NamemedicationStatementOrRequest
                                          Control0..1
                                          TypeReference(Medication Statement (EPS), MedicationRequest (EPS))
                                          72. Composition.section:sectionImmunizations
                                          Slice NamesectionImmunizations
                                          Definition

                                          The immunizations section contains a narrative description of the immunizations administered to the patient in the past. It includes entries for medication administration as described in related profiles

                                          ShortImmunizations
                                          Control0..1
                                          Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                          74. Composition.section:sectionImmunizations.extension:section-note
                                          Slice Namesection-note
                                          Definition

                                          Additional notes that apply to the section (but not to specific resource).

                                          ShortAdditional notes that apply to the section (but not to specific resource).
                                          Control0..*
                                          TypeExtension(Note) (Extension Type: Annotation)
                                          76. Composition.section:sectionImmunizations.code
                                          TypeCodeableConcept(Codeable Concept (IPS))
                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "http://loinc.org",
                                              "code" : "11369-6"
                                            }]
                                          }
                                          78. Composition.section:sectionImmunizations.entry
                                          Definition

                                          It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.

                                          ShortPatient's immunization status and pertinent history.
                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • type @ resolve()
                                          • 80. Composition.section:sectionImmunizations.entry:immunization
                                            Slice Nameimmunization
                                            Definition

                                            DESCR Immunizartion

                                            ShortSHORT Immunization
                                            Control0..1
                                            TypeReference(Immunization (EPS))
                                            82. Composition.section:sectionResults
                                            Slice NamesectionResults
                                            ShortCoded Results
                                            Control0..1
                                            84. Composition.section:sectionProceduresHx
                                            Slice NamesectionProceduresHx
                                            Definition

                                            DESC Procedures

                                            ShortHistory of Procedures
                                            Control0..1
                                            Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                            86. Composition.section:sectionProceduresHx.extension:section-note
                                            Slice Namesection-note
                                            Definition

                                            Additional notes that apply to the section (but not to specific resource).

                                            ShortAdditional notes that apply to the section (but not to specific resource).
                                            Control0..*
                                            TypeExtension(Note) (Extension Type: Annotation)
                                            88. Composition.section:sectionProceduresHx.code
                                            TypeCodeableConcept(Codeable Concept (IPS))
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "47519-4"
                                              }]
                                            }
                                            90. Composition.section:sectionProceduresHx.entry
                                            Definition

                                            DESC Procedures

                                            ShortPatient past procedures pertinent to the scope of this document.
                                            TypeReference(Procedure, DocumentReference)
                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • type @ resolve()
                                            • 92. Composition.section:sectionProceduresHx.entry:procedure
                                              Slice Nameprocedure
                                              Definition

                                              It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.

                                              ShortClinical problems or conditions currently being monitored for the patient.
                                              Control0..1
                                              TypeReference(Procedure (EPS))
                                              94. Composition.section:sectionMedicalDevices
                                              Slice NamesectionMedicalDevices
                                              Definition

                                              The medical devices section contains a narrative description of the medical devices used by the patient in the past. It includes entries for device use as described in related profiles

                                              ShortMedical Devices
                                              Control0..1
                                              Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                              96. Composition.section:sectionMedicalDevices.extension:section-note
                                              Slice Namesection-note
                                              Definition

                                              Additional notes that apply to the section (but not to specific resource).

                                              ShortAdditional notes that apply to the section (but not to specific resource).
                                              Control0..*
                                              TypeExtension(Note) (Extension Type: Annotation)
                                              98. Composition.section:sectionMedicalDevices.code
                                              TypeCodeableConcept(Codeable Concept (IPS))
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "46264-8"
                                                }]
                                              }
                                              100. Composition.section:sectionMedicalDevices.entry
                                              Definition

                                              Med devices Description

                                              ShortMed Device short
                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • type @ resolve()
                                              • 102. Composition.section:sectionMedicalDevices.entry:deviceStatement
                                                Slice NamedeviceStatement
                                                Definition

                                                DESCR deviceStatement

                                                ShortSHORT deviceStatement
                                                Control0..1
                                                TypeReference(DeviceUseStatement (EPS))
                                                104. Composition.section:sectionAdvanceDirectives
                                                Slice NamesectionAdvanceDirectives
                                                Definition

                                                The advance directives section contains a narrative description of patient's advance directive.

                                                ShortAdvance Directives Section
                                                Control0..1
                                                Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                106. Composition.section:sectionAdvanceDirectives.extension:section-note
                                                Slice Namesection-note
                                                Definition

                                                Additional notes that apply to the section (but not to specific resource).

                                                ShortAdditional notes that apply to the section (but not to specific resource).
                                                Control0..*
                                                TypeExtension(Note) (Extension Type: Annotation)
                                                108. Composition.section:sectionAdvanceDirectives.code
                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "42348-3"
                                                  }]
                                                }
                                                110. Composition.section:sectionAdvanceDirectives.entry
                                                TypeReference(Consent (Advance Directives EPS), DocumentReference)
                                                112. Composition.section:sectionAlerts
                                                Slice NamesectionAlerts
                                                Control0..1
                                                114. Composition.section:sectionFunctionalStatus
                                                Slice NamesectionFunctionalStatus
                                                Definition

                                                The functional status section contains a narrative description of the patient's functional status. It includes entries for functional status as described in related profiles

                                                ShortFunctional Status
                                                Control0..1
                                                Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                116. Composition.section:sectionFunctionalStatus.extension:section-note
                                                Slice Namesection-note
                                                Definition

                                                Additional notes that apply to the section (but not to specific resource).

                                                ShortAdditional notes that apply to the section (but not to specific resource).
                                                Control0..*
                                                TypeExtension(Note) (Extension Type: Annotation)
                                                118. Composition.section:sectionFunctionalStatus.code
                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "47420-5"
                                                  }]
                                                }
                                                120. Composition.section:sectionFunctionalStatus.entry
                                                Definition

                                                Functional Status Description

                                                ShortFunctional Status short
                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • type @ resolve()
                                                • 122. Composition.section:sectionFunctionalStatus.entry:functionalStatus
                                                  Slice NamefunctionalStatus
                                                  Definition

                                                  DESCR functionalStatus

                                                  ShortSHORT functionalStatus
                                                  Control0..1
                                                  TypeReference(Condition (EPS))
                                                  124. Composition.section:sectionPastProblems
                                                  Slice NamesectionPastProblems
                                                  Definition

                                                  The past problems section contains a narrative description of the patient's past problems. It includes entries for problems as described in related profiles

                                                  ShortPast Problems
                                                  Control0..1
                                                  Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                  126. Composition.section:sectionPastProblems.extension:section-note
                                                  Slice Namesection-note
                                                  Definition

                                                  Additional notes that apply to the section (but not to specific resource).

                                                  ShortAdditional notes that apply to the section (but not to specific resource).
                                                  Control0..*
                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                  128. Composition.section:sectionPastProblems.code
                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "8716-3"
                                                    }]
                                                  }
                                                  130. Composition.section:sectionPastProblems.entry
                                                  Definition

                                                  Past Problems Description

                                                  ShortPast Problems short
                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • type @ resolve()
                                                  • 132. Composition.section:sectionPastProblems.entry:pastProblem
                                                    Slice NamepastProblem
                                                    Definition

                                                    DESCR pastProblem

                                                    ShortSHORT pastProblem
                                                    Control0..1
                                                    TypeReference(Condition (EPS))
                                                    134. Composition.section:sectionPregnancyHx
                                                    Slice NamesectionPregnancyHx
                                                    Definition

                                                    The pregnancy history section contains a narrative description of the patient's pregnancy history. It includes entries for pregnancy history as described in related profiles

                                                    ShortPregnancy History
                                                    Control0..1
                                                    Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                    136. Composition.section:sectionPregnancyHx.extension:section-note
                                                    Slice Namesection-note
                                                    Definition

                                                    Additional notes that apply to the section (but not to specific resource).

                                                    ShortAdditional notes that apply to the section (but not to specific resource).
                                                    Control0..*
                                                    TypeExtension(Note) (Extension Type: Annotation)
                                                    138. Composition.section:sectionPregnancyHx.code
                                                    TypeCodeableConcept(Codeable Concept (IPS))
                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://loinc.org",
                                                        "code" : "10162-6"
                                                      }]
                                                    }
                                                    140. Composition.section:sectionPregnancyHx.entry
                                                    Definition

                                                    Pregnancy History Description

                                                    ShortPregnancy History short
                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • type @ resolve()
                                                    • 142. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
                                                      Slice NamepregnancyStatus
                                                      Definition

                                                      DESCR Pregnancy status

                                                      ShortPregnancy status
                                                      Control0..1
                                                      TypeReference(Observation Pregnancy - Status (IPS))
                                                      144. Composition.section:sectionPregnancyHx.entry:pregnancyOutcome
                                                      Slice NamepregnancyOutcome
                                                      Definition

                                                      DESCR Pregnancy outcome

                                                      ShortPregnancy outcome
                                                      Control0..1
                                                      TypeReference(Observation Pregnancy - Outcome (IPS))
                                                      146. Composition.section:sectionPatientStory
                                                      Slice NamesectionPatientStory
                                                      Control0..1
                                                      148. Composition.section:sectionPlanOfCare
                                                      Slice NamesectionPlanOfCare
                                                      Definition

                                                      The health maintenance care plan section contains a description of the expectations for wellness care including proposals, goals, and order requests for monitoring, tracking, or improving the lifetime condition of the patient with goals of educating the patient on how to reduce the modifiable risks of the patient\’s genetic, behavioral, and environmental pre-conditions and otherwise optimizing lifetime outcomes.

                                                      ShortHealth Maintenance Care Plan
                                                      Control0..1
                                                      150. Composition.section:sectionSocialHistory
                                                      Slice NamesectionSocialHistory
                                                      Definition

                                                      The social history section contains a narrative description of the person\’s beliefs, home life, community life, work life, hobbies, and risky habits. It includes Social History Observations.

                                                      ShortSocial History
                                                      Control0..1
                                                      152. Composition.section:sectionVitalSigns
                                                      Slice NamesectionVitalSigns
                                                      Definition

                                                      The vital signs section contains a narrative description of the patient's vital signs. It includes entries for vital sign measurements as described in related profiles

                                                      ShortVital Signs
                                                      Control0..1
                                                      Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                      154. Composition.section:sectionVitalSigns.extension:section-note
                                                      Slice Namesection-note
                                                      Definition

                                                      Additional notes that apply to the section (but not to specific resource).

                                                      ShortAdditional notes that apply to the section (but not to specific resource).
                                                      Control0..*
                                                      TypeExtension(Note) (Extension Type: Annotation)
                                                      156. Composition.section:sectionVitalSigns.code
                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "8716-3"
                                                        }]
                                                      }
                                                      158. Composition.section:sectionVitalSigns.entry
                                                      Definition

                                                      Vital Signs Description

                                                      ShortVital Signs short
                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • type @ resolve()
                                                      • 160. Composition.section:sectionVitalSigns.entry:vitalSign
                                                        Slice NamevitalSign
                                                        Definition

                                                        DESCR vitalSign

                                                        ShortSHORT vitalSign
                                                        Control0..1
                                                        TypeReference(Vital Signs Profile)
                                                        162. Composition.section:sectionAlert
                                                        Slice NamesectionAlert
                                                        Definition

                                                        Information used to warn or call to a state of preparedness. Information flagged or intended to raise awareness of a potential danger to from the subject of the IPS or to from another individual or awareness of a potential obstacle to care.

                                                        ShortAlerts Section
                                                        Control0..1
                                                        Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                        164. Composition.section:sectionAlert.extension:section-note
                                                        Slice Namesection-note
                                                        Definition

                                                        Additional notes that apply to the section (but not to specific resource).

                                                        ShortAdditional notes that apply to the section (but not to specific resource).
                                                        Control0..*
                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                        166. Composition.section:sectionAlert.code
                                                        TypeCodeableConcept(Codeable Concept (IPS))
                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://loinc.org",
                                                            "code" : "104605-1"
                                                          }]
                                                        }
                                                        168. Composition.section:sectionAlert.entry
                                                        Definition

                                                        Alerts

                                                        ShortAlerts
                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • type @ resolve()
                                                        • 170. Composition.section:sectionAlert.entry:flag
                                                          Slice Nameflag
                                                          Definition

                                                          Flags

                                                          ShortFlags
                                                          Control0..1
                                                          TypeReference(Flag (EU core) [WIP])
                                                          172. Composition.section:sectionTravelHx
                                                          Slice NamesectionTravelHx
                                                          Definition

                                                          This Section describes the travel history relevant for the Patient Summary, e.g.recent travel in a region of high prevalence of a specific infectious disease like Malaria

                                                          ShortTravel History Section
                                                          Control0..1
                                                          Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                          174. Composition.section:sectionTravelHx.extension:section-note
                                                          Slice Namesection-note
                                                          Definition

                                                          Additional notes that apply to the section (but not to specific resource).

                                                          ShortAdditional notes that apply to the section (but not to specific resource).
                                                          Control0..*
                                                          TypeExtension(Note) (Extension Type: Annotation)
                                                          176. Composition.section:sectionTravelHx.code
                                                          TypeCodeableConcept(Codeable Concept (IPS))
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "10182-4"
                                                            }]
                                                          }
                                                          178. Composition.section:sectionTravelHx.entry
                                                          TypeReference(Observation: country visited (HDR))
                                                          180. Composition.section:sectionPatientHx
                                                          Slice NamesectionPatientHx
                                                          Definition

                                                          This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.

                                                          ShortPatient History Section
                                                          Control0..1
                                                          Invariantsips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                          182. Composition.section:sectionPatientHx.extension:section-note
                                                          Slice Namesection-note
                                                          Definition

                                                          Additional notes that apply to the section (but not to specific resource).

                                                          ShortAdditional notes that apply to the section (but not to specific resource).
                                                          Control0..*
                                                          TypeExtension(Note) (Extension Type: Annotation)
                                                          184. Composition.section:sectionPatientHx.code
                                                          TypeCodeableConcept(Codeable Concept (IPS))
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "11329-0"
                                                            }]
                                                          }

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

                                                          0. Composition
                                                          Definition

                                                          Patient Summary composition. A composition is 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.

                                                          ShortPatient Summary composition
                                                          Comments

                                                          While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

                                                          Control0..*
                                                          Is Modifierfalse
                                                          Impose ProfileThis profile also requires that the instance also conform this additional profile:
                                                          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. Composition.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. Composition.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. Composition.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. Composition.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|4.0.1)

                                                          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. Composition.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. Composition.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. Composition.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          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 Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 16. Composition.extension:version
                                                            Slice Nameversion
                                                            Definition

                                                            This cross-version extension represents Composition.version from http://hl7.org/fhir/StructureDefinition/Composition|5.0.0 for use in FHIR R4.

                                                            ShortBusiness version
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
                                                            Is Modifierfalse
                                                            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())
                                                            18. Composition.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())
                                                            20. Composition.identifier
                                                            Definition

                                                            A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

                                                            ShortPS business identifier
                                                            Comments

                                                            Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

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

                                                            The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

                                                            ShortPS status
                                                            Comments

                                                            If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

                                                            Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

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

                                                            The workflow/clinical status of the composition.

                                                            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
                                                            Requirements

                                                            Need to be able to mark interim, amended, or withdrawn compositions or documents.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            24. Composition.type
                                                            Definition

                                                            Specifies that this composition refer to a Patient Summary

                                                            ShortKind of composition ("Patient Summary")
                                                            Comments

                                                            For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

                                                            Control1..1
                                                            BindingThe codes SHOULD be taken from FHIRDocumentTypeCodes
                                                            (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1)

                                                            Type of a composition.

                                                            TypeCodeableConcept(Codeable Concept (IPS))
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Key metadata element describing the composition, used in searching/filtering.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            26. Composition.category
                                                            Definition

                                                            A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

                                                            ShortCategorization of Composition
                                                            Comments

                                                            This is a metadata field from XDS/MHD.

                                                            Control0..*
                                                            BindingFor example codes, see DocumentClassValueSet
                                                            (example to http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1)

                                                            High-level kind of a clinical document at a macro level.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            28. Composition.subject
                                                            Definition

                                                            Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the PS the subject is always the patient.

                                                            ShortWho and/or what the composition is about
                                                            Comments

                                                            For clinical documents, this is usually the patient.

                                                            Control1..1
                                                            TypeReference(Patient (EPS))
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            30. Composition.encounter
                                                            Definition

                                                            Describes the clinical encounter or type of care this documentation is associated with.

                                                            ShortContext of the Composition
                                                            Control0..1
                                                            TypeReference(Encounter)
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Provides context for the composition and supports searching.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            32. Composition.date
                                                            Definition

                                                            The composition editing time, when the composition was last logically changed by the author.

                                                            ShortPS date
                                                            Comments

                                                            The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                                                            Control1..1
                                                            TypedateTime
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            34. Composition.author
                                                            Definition

                                                            Identifies who is responsible for the information in the Patient Summary, not necessarily who typed it in.

                                                            ShortWho and/or what authored the Patient Summary
                                                            Control1..*
                                                            TypeReference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Patient (EU core), RelatedPerson)
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Identifies who is responsible for the content.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            36. Composition.title
                                                            Definition

                                                            Official human-readable label for the composition.

                                                            For this document should be "Patient Summary" or any equivalent translation

                                                            ShortPatient Summary
                                                            Comments

                                                            For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                                                            Control1..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            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()))
                                                            38. Composition.confidentiality
                                                            Definition

                                                            The code specifying the level of confidentiality of the Composition.

                                                            ShortAs defined by affinity domain
                                                            Comments

                                                            The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

                                                            Control0..1
                                                            BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
                                                            (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                                            Codes specifying the level of confidentiality of the composition.

                                                            Typecode
                                                            Is Modifierfalse
                                                            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()))
                                                            40. Composition.attester
                                                            Definition

                                                            A participant who has attested to the accuracy of the composition/document.

                                                            ShortAttests to accuracy of composition
                                                            Comments

                                                            Only list each attester once.

                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Identifies responsibility for the accuracy of the composition content.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            42. Composition.attester.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. Composition.attester.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. Composition.attester.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. Composition.attester.mode
                                                            Definition

                                                            The type of attestation the authenticator offers.

                                                            ShortThe type of attestation
                                                            Control1..1
                                                            BindingThe codes SHALL be taken from CompositionAttestationMode
                                                            (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                                            The way in which a person authenticated a composition.

                                                            Typecode
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summaryfalse
                                                            Requirements

                                                            Indicates the level of authority of the attestation.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            50. Composition.attester.time
                                                            Definition

                                                            When the composition was attested by the party.

                                                            ShortWhen the composition was attested
                                                            Control0..1
                                                            TypedateTime
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summaryfalse
                                                            Requirements

                                                            Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            52. Composition.attester.party
                                                            Definition

                                                            Who attested the composition in the specified way.

                                                            ShortWho attested the composition
                                                            Control0..1
                                                            TypeReference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Patient (EPS), RelatedPerson)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Identifies who has taken on the responsibility for accuracy of the composition content.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            54. Composition.custodian
                                                            Definition

                                                            Identifies the organization that is responsible for ongoing maintenance of the Patient Summary, and ensures that it remains available for access by other parties.

                                                            ShortCustodian of the Patient Summary
                                                            Comments

                                                            This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                                                            Control0..1
                                                            TypeReference(Organization (EU core))
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Identifies where to go to find the current version, where to report issues, etc.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            56. Composition.relatesTo
                                                            Definition

                                                            Relationships that this composition has with other compositions or documents that already exist.

                                                            ShortRelationships to other compositions/documents
                                                            Comments

                                                            A document is a version specific composition.

                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            58. Composition.relatesTo.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
                                                            60. Composition.relatesTo.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())
                                                            62. Composition.relatesTo.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())
                                                            64. Composition.relatesTo.code
                                                            Definition

                                                            The type of relationship that this composition has with anther composition or document.

                                                            Shortreplaces | transforms | signs | appends
                                                            Comments

                                                            If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

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

                                                            The type of relationship between documents.

                                                            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()))
                                                            66. Composition.relatesTo.target[x]
                                                            Definition

                                                            The target composition/document of this relationship.

                                                            ShortTarget of the relationship
                                                            Control1..1
                                                            TypeChoice of: Identifier, Reference(Composition)
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            68. Composition.event
                                                            Definition

                                                            The clinical service, such as a colonoscopy or an appendectomy, being documented.

                                                            ShortThe clinical service(s) being documented
                                                            Comments

                                                            The event needs to be consistent with the type element, though can provide further information if desired.

                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            70. Composition.event.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
                                                            72. Composition.event.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())
                                                            74. Composition.event.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())
                                                            76. Composition.event.code
                                                            Definition

                                                            This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                                            ShortCode(s) that apply to the event being documented
                                                            Comments

                                                            An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                                            Control0..*
                                                            BindingFor example codes, see v3 Code System ActCode
                                                            (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

                                                            This list of codes represents the main clinical acts being documented.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            78. Composition.event.period
                                                            Definition

                                                            The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

                                                            ShortThe period covered by the documentation
                                                            Control0..1
                                                            TypePeriod
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            80. Composition.event.detail
                                                            Definition

                                                            The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                                            ShortThe event(s) being documented
                                                            Control0..*
                                                            TypeReference(Resource)
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            82. Composition.section
                                                            Definition

                                                            The root of the sections that make up the IPS composition.

                                                            ShortSections composing the IPS
                                                            Control3..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ code
                                                            • 84. Composition.section.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
                                                              86. Composition.section.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 88. Composition.section.extension:section-note
                                                                Slice Namesection-note
                                                                Definition

                                                                Additional notes that apply to the section (but not to specific resource).

                                                                ShortAdditional notes that apply to the section (but not to specific resource).
                                                                Comments

                                                                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                Control0..*
                                                                TypeExtension(Note) (Extension Type: Annotation)
                                                                Is Modifierfalse
                                                                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())
                                                                90. Composition.section.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())
                                                                92. Composition.section.title
                                                                Definition

                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                ShortLabel for section (e.g. for ToC)
                                                                Comments

                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                Control1..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summaryfalse
                                                                Requirements

                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                Alternate Namesheader, label, caption
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                94. Composition.section.code
                                                                Definition

                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                ShortClassification of section (recommended)
                                                                Comments

                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                Control1..1
                                                                BindingFor example codes, see DocumentSectionCodes
                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                Classification of a section of a composition/document.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides computable standardized labels to topics within the document.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                96. Composition.section.author
                                                                Definition

                                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                ShortWho and/or what authored the section
                                                                Control0..*
                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Identifies who is responsible for the content.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                98. Composition.section.focus
                                                                Definition

                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                Comments

                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                A human-readable narrative that contains the attested content of the section, 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.

                                                                ShortText summary of the section, for human interpretation
                                                                Comments

                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                Control1..1
                                                                This element is affected by the following invariants: cmp-1
                                                                TypeNarrative
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                102. Composition.section.mode
                                                                Definition

                                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                Shortworking | snapshot | changes
                                                                Comments

                                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                Control0..1
                                                                BindingThe codes SHALL be taken from ListMode
                                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                The processing mode that applies to this section.

                                                                Typecode
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summaryfalse
                                                                Requirements

                                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                104. Composition.section.orderedBy
                                                                Definition

                                                                Specifies the order applied to the items in the section entries.

                                                                ShortOrder of section entries
                                                                Comments

                                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                Control0..1
                                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                                (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                What order applies to the items in the entry.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                106. Composition.section.entry
                                                                Definition

                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                ShortA reference to data that supports this section
                                                                Comments

                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(Resource)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                108. Composition.section.emptyReason
                                                                Definition

                                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                ShortWhy the section is empty
                                                                Comments

                                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                Control0..1
                                                                This element is affected by the following invariants: cmp-2
                                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                If a section is empty, why it is empty.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                110. Composition.section.section
                                                                Definition

                                                                A nested sub-section within this section.

                                                                ShortNested Section
                                                                Comments

                                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                Control0..0
                                                                This element is affected by the following invariants: cmp-1
                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                112. Composition.section:sectionProblems
                                                                Slice NamesectionProblems
                                                                Definition

                                                                Active Problems Section description

                                                                ShortActive Problems
                                                                Control1..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                114. Composition.section:sectionProblems.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
                                                                116. Composition.section:sectionProblems.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 118. Composition.section:sectionProblems.extension:section-note
                                                                  Slice Namesection-note
                                                                  Definition

                                                                  Additional notes that apply to the section (but not to specific resource).

                                                                  ShortAdditional notes that apply to the section (but not to specific resource).
                                                                  Comments

                                                                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                  Control0..*
                                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                                  Is Modifierfalse
                                                                  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())
                                                                  120. Composition.section:sectionProblems.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())
                                                                  122. Composition.section:sectionProblems.title
                                                                  Definition

                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                  ShortLabel for section (e.g. for ToC)
                                                                  Comments

                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                  Control1..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                  Alternate Namesheader, label, caption
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  124. Composition.section:sectionProblems.code
                                                                  Definition

                                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                  ShortClassification of section (recommended)
                                                                  Comments

                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                  Control1..1
                                                                  BindingFor example codes, see DocumentSectionCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                  Classification of a section of a composition/document.

                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Provides computable standardized labels to topics within the document.

                                                                  Pattern Value{
                                                                    "coding" : [{
                                                                      "system" : "http://loinc.org",
                                                                      "code" : "11450-4"
                                                                    }]
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  126. Composition.section:sectionProblems.author
                                                                  Definition

                                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                  ShortWho and/or what authored the section
                                                                  Control0..*
                                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Identifies who is responsible for the content.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  128. Composition.section:sectionProblems.focus
                                                                  Definition

                                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                                  Comments

                                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                                  ShortText summary of the section, for human interpretation
                                                                  Comments

                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                  Control1..1
                                                                  This element is affected by the following invariants: cmp-1
                                                                  TypeNarrative
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  132. Composition.section:sectionProblems.mode
                                                                  Definition

                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                  Shortworking | snapshot | changes
                                                                  Comments

                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from ListMode
                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                  The processing mode that applies to this section.

                                                                  Typecode
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  134. Composition.section:sectionProblems.orderedBy
                                                                  Definition

                                                                  Specifies the order applied to the items in the section entries.

                                                                  ShortOrder of section entries
                                                                  Comments

                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                  Control0..1
                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                  What order applies to the items in the entry.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  136. Composition.section:sectionProblems.entry
                                                                  Definition

                                                                  DESC Problems

                                                                  ShortActive Problems
                                                                  Comments

                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(Condition, DocumentReference)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • type @ resolve()
                                                                  • 138. Composition.section:sectionProblems.entry:problem
                                                                    Slice Nameproblem
                                                                    Definition

                                                                    It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.

                                                                    ShortClinical problems or conditions currently being monitored for the patient.
                                                                    Comments

                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(Condition (EPS))
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    140. Composition.section:sectionProblems.emptyReason
                                                                    Definition

                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                    ShortWhy the section is empty
                                                                    Comments

                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: cmp-2
                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                    If a section is empty, why it is empty.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    142. Composition.section:sectionProblems.section
                                                                    Definition

                                                                    A nested sub-section within this section.

                                                                    ShortNested Section
                                                                    Comments

                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                    Control0..0
                                                                    This element is affected by the following invariants: cmp-1
                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    144. Composition.section:sectionAllergies
                                                                    Slice NamesectionAllergies
                                                                    Definition

                                                                    Allergy section description

                                                                    ShortAllergies and Other Adverse Reactions
                                                                    Control1..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                    146. Composition.section:sectionAllergies.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
                                                                    148. Composition.section:sectionAllergies.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 150. Composition.section:sectionAllergies.extension:section-note
                                                                      Slice Namesection-note
                                                                      Definition

                                                                      Additional notes that apply to the section (but not to specific resource).

                                                                      ShortAdditional notes that apply to the section (but not to specific resource).
                                                                      Comments

                                                                      This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                      Control0..*
                                                                      TypeExtension(Note) (Extension Type: Annotation)
                                                                      Is Modifierfalse
                                                                      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())
                                                                      152. Composition.section:sectionAllergies.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())
                                                                      154. Composition.section:sectionAllergies.title
                                                                      Definition

                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                      ShortLabel for section (e.g. for ToC)
                                                                      Comments

                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                      Control1..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                      Alternate Namesheader, label, caption
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      156. Composition.section:sectionAllergies.code
                                                                      Definition

                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                      ShortClassification of section (recommended)
                                                                      Comments

                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                      Control1..1
                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                      Classification of a section of a composition/document.

                                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Provides computable standardized labels to topics within the document.

                                                                      Pattern Value{
                                                                        "coding" : [{
                                                                          "system" : "http://loinc.org",
                                                                          "code" : "48765-2"
                                                                        }]
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      158. Composition.section:sectionAllergies.author
                                                                      Definition

                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                      ShortWho and/or what authored the section
                                                                      Control0..*
                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Identifies who is responsible for the content.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      160. Composition.section:sectionAllergies.focus
                                                                      Definition

                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                      Comments

                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                      A human-readable narrative that contains the attested content of the section, 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.

                                                                      ShortText summary of the section, for human interpretation
                                                                      Comments

                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                      Control1..1
                                                                      This element is affected by the following invariants: cmp-1
                                                                      TypeNarrative
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      164. Composition.section:sectionAllergies.mode
                                                                      Definition

                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                      Shortworking | snapshot | changes
                                                                      Comments

                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                      Control0..1
                                                                      BindingThe codes SHALL be taken from ListMode
                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                      The processing mode that applies to this section.

                                                                      Typecode
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      166. Composition.section:sectionAllergies.orderedBy
                                                                      Definition

                                                                      Specifies the order applied to the items in the section entries.

                                                                      ShortOrder of section entries
                                                                      Comments

                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                      Control0..1
                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                      What order applies to the items in the entry.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      168. Composition.section:sectionAllergies.entry
                                                                      Definition

                                                                      allergyOrIntolerance

                                                                      ShortallergyOrIntolerance
                                                                      Comments

                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(AllergyIntolerance, DocumentReference)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • type @ resolve()
                                                                      • 170. Composition.section:sectionAllergies.entry:allergyOrIntolerance
                                                                        Slice NameallergyOrIntolerance
                                                                        Definition

                                                                        Description

                                                                        ShortRelevant allergies or intolerances for that patient.
                                                                        Comments

                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: cmp-2
                                                                        TypeReference(Allergy Intolerance (EU core) [WIP])
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        172. Composition.section:sectionAllergies.emptyReason
                                                                        Definition

                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                        ShortWhy the section is empty
                                                                        Comments

                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: cmp-2
                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                        If a section is empty, why it is empty.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        174. Composition.section:sectionAllergies.section
                                                                        Definition

                                                                        A nested sub-section within this section.

                                                                        ShortNested Section
                                                                        Comments

                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                        Control0..0
                                                                        This element is affected by the following invariants: cmp-1
                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        176. Composition.section:sectionMedications
                                                                        Slice NamesectionMedications
                                                                        Definition

                                                                        The medication summary section contains a description of the patient's medications as part of the patient summary

                                                                        ShortMedication Summary
                                                                        Control1..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                        178. Composition.section:sectionMedications.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
                                                                        180. Composition.section:sectionMedications.extension
                                                                        Definition

                                                                        An Extension

                                                                        ShortExtension
                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 182. Composition.section:sectionMedications.extension:section-note
                                                                          Slice Namesection-note
                                                                          Definition

                                                                          Additional notes that apply to the section (but not to specific resource).

                                                                          ShortAdditional notes that apply to the section (but not to specific resource).
                                                                          Comments

                                                                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                          Control0..*
                                                                          TypeExtension(Note) (Extension Type: Annotation)
                                                                          Is Modifierfalse
                                                                          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())
                                                                          184. Composition.section:sectionMedications.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())
                                                                          186. Composition.section:sectionMedications.title
                                                                          Definition

                                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                          ShortLabel for section (e.g. for ToC)
                                                                          Comments

                                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                          Control1..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                          Alternate Namesheader, label, caption
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          188. Composition.section:sectionMedications.code
                                                                          Definition

                                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                          ShortClassification of section (recommended)
                                                                          Comments

                                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                          Control1..1
                                                                          BindingFor example codes, see DocumentSectionCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                          Classification of a section of a composition/document.

                                                                          TypeCodeableConcept(Codeable Concept (IPS))
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Provides computable standardized labels to topics within the document.

                                                                          Pattern Value{
                                                                            "coding" : [{
                                                                              "system" : "http://loinc.org",
                                                                              "code" : "10160-0"
                                                                            }]
                                                                          }
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          190. Composition.section:sectionMedications.author
                                                                          Definition

                                                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                          ShortWho and/or what authored the section
                                                                          Control0..*
                                                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Identifies who is responsible for the content.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          192. Composition.section:sectionMedications.focus
                                                                          Definition

                                                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                          ShortWho/what the section is about, when it is not about the subject of composition
                                                                          Comments

                                                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                          A human-readable narrative that contains the attested content of the section, 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.

                                                                          ShortText summary of the section, for human interpretation
                                                                          Comments

                                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                          Control1..1
                                                                          This element is affected by the following invariants: cmp-1
                                                                          TypeNarrative
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          196. Composition.section:sectionMedications.mode
                                                                          Definition

                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                          Shortworking | snapshot | changes
                                                                          Comments

                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                          Control0..1
                                                                          BindingThe codes SHALL be taken from ListMode
                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                          The processing mode that applies to this section.

                                                                          Typecode
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          198. Composition.section:sectionMedications.orderedBy
                                                                          Definition

                                                                          Specifies the order applied to the items in the section entries.

                                                                          ShortOrder of section entries
                                                                          Comments

                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                          Control0..1
                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                          What order applies to the items in the entry.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          200. Composition.section:sectionMedications.entry
                                                                          Definition

                                                                          medicationStatementOrRequest

                                                                          ShortmedicationStatementOrRequest
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(Medication Statement (EPS), MedicationRequest (EPS), MedicationAdministration (EPS), MedicationDispense (EPS))
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • type @ resolve()
                                                                          • 202. Composition.section:sectionMedications.entry:medicationStatementOrRequest
                                                                            Slice NamemedicationStatementOrRequest
                                                                            Definition

                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                            ShortA reference to data that supports this section
                                                                            Comments

                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: cmp-2
                                                                            TypeReference(Medication Statement (EPS), MedicationRequest (EPS))
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            204. Composition.section:sectionMedications.emptyReason
                                                                            Definition

                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                            ShortWhy the section is empty
                                                                            Comments

                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: cmp-2
                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                            If a section is empty, why it is empty.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            206. Composition.section:sectionMedications.section
                                                                            Definition

                                                                            A nested sub-section within this section.

                                                                            ShortNested Section
                                                                            Comments

                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                            Control0..0
                                                                            This element is affected by the following invariants: cmp-1
                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            208. Composition.section:sectionImmunizations
                                                                            Slice NamesectionImmunizations
                                                                            Definition

                                                                            The immunizations section contains a narrative description of the immunizations administered to the patient in the past. It includes entries for medication administration as described in related profiles

                                                                            ShortImmunizations
                                                                            Control0..1
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                            210. Composition.section:sectionImmunizations.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
                                                                            212. Composition.section:sectionImmunizations.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 214. Composition.section:sectionImmunizations.extension:section-note
                                                                              Slice Namesection-note
                                                                              Definition

                                                                              Additional notes that apply to the section (but not to specific resource).

                                                                              ShortAdditional notes that apply to the section (but not to specific resource).
                                                                              Comments

                                                                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                              Control0..*
                                                                              TypeExtension(Note) (Extension Type: Annotation)
                                                                              Is Modifierfalse
                                                                              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())
                                                                              216. Composition.section:sectionImmunizations.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())
                                                                              218. Composition.section:sectionImmunizations.title
                                                                              Definition

                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                              ShortLabel for section (e.g. for ToC)
                                                                              Comments

                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                              Control1..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                              Alternate Namesheader, label, caption
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              220. Composition.section:sectionImmunizations.code
                                                                              Definition

                                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                              ShortClassification of section (recommended)
                                                                              Comments

                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                              Control1..1
                                                                              BindingFor example codes, see DocumentSectionCodes
                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                              Classification of a section of a composition/document.

                                                                              TypeCodeableConcept(Codeable Concept (IPS))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Provides computable standardized labels to topics within the document.

                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "http://loinc.org",
                                                                                  "code" : "11369-6"
                                                                                }]
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              222. Composition.section:sectionImmunizations.author
                                                                              Definition

                                                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                              ShortWho and/or what authored the section
                                                                              Control0..*
                                                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Identifies who is responsible for the content.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              224. Composition.section:sectionImmunizations.focus
                                                                              Definition

                                                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                              ShortWho/what the section is about, when it is not about the subject of composition
                                                                              Comments

                                                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                              A human-readable narrative that contains the attested content of the section, 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.

                                                                              ShortText summary of the section, for human interpretation
                                                                              Comments

                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                              Control1..1
                                                                              This element is affected by the following invariants: cmp-1
                                                                              TypeNarrative
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              228. Composition.section:sectionImmunizations.mode
                                                                              Definition

                                                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                              Shortworking | snapshot | changes
                                                                              Comments

                                                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                              Control0..1
                                                                              BindingThe codes SHALL be taken from ListMode
                                                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                              The processing mode that applies to this section.

                                                                              Typecode
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              230. Composition.section:sectionImmunizations.orderedBy
                                                                              Definition

                                                                              Specifies the order applied to the items in the section entries.

                                                                              ShortOrder of section entries
                                                                              Comments

                                                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                              Control0..1
                                                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                              What order applies to the items in the entry.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              232. Composition.section:sectionImmunizations.entry
                                                                              Definition

                                                                              It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.

                                                                              ShortPatient's immunization status and pertinent history.
                                                                              Comments

                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: cmp-2
                                                                              TypeReference(Resource)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • type @ resolve()
                                                                              • 234. Composition.section:sectionImmunizations.entry:immunization
                                                                                Slice Nameimmunization
                                                                                Definition

                                                                                DESCR Immunizartion

                                                                                ShortSHORT Immunization
                                                                                Comments

                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: cmp-2
                                                                                TypeReference(Immunization (EPS))
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                236. Composition.section:sectionImmunizations.emptyReason
                                                                                Definition

                                                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                ShortWhy the section is empty
                                                                                Comments

                                                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: cmp-2
                                                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                If a section is empty, why it is empty.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                238. Composition.section:sectionImmunizations.section
                                                                                Definition

                                                                                A nested sub-section within this section.

                                                                                ShortNested Section
                                                                                Comments

                                                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                Control0..0
                                                                                This element is affected by the following invariants: cmp-1
                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                240. Composition.section:sectionResults
                                                                                Slice NamesectionResults
                                                                                Definition

                                                                                The root of the sections that make up the composition.

                                                                                ShortCoded Results
                                                                                Control0..1
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                242. Composition.section:sectionResults.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
                                                                                244. Composition.section:sectionResults.extension
                                                                                Definition

                                                                                An Extension

                                                                                ShortExtension
                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 246. Composition.section:sectionResults.extension:section-note
                                                                                  Slice Namesection-note
                                                                                  Definition

                                                                                  Additional notes that apply to the section (but not to specific resource).

                                                                                  ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                  Comments

                                                                                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                  Control0..*
                                                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                                                  Is Modifierfalse
                                                                                  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())
                                                                                  248. Composition.section:sectionResults.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())
                                                                                  250. Composition.section:sectionResults.title
                                                                                  Definition

                                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                  ShortLabel for section (e.g. for ToC)
                                                                                  Comments

                                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                  Control1..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                  Alternate Namesheader, label, caption
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  252. Composition.section:sectionResults.code
                                                                                  Definition

                                                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                  ShortClassification of section (recommended)
                                                                                  Comments

                                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                  Control1..1
                                                                                  BindingFor example codes, see DocumentSectionCodes
                                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                  Classification of a section of a composition/document.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Provides computable standardized labels to topics within the document.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  254. Composition.section:sectionResults.author
                                                                                  Definition

                                                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                  ShortWho and/or what authored the section
                                                                                  Control0..*
                                                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Identifies who is responsible for the content.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  256. Composition.section:sectionResults.focus
                                                                                  Definition

                                                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                                                  Comments

                                                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                                                  ShortText summary of the section, for human interpretation
                                                                                  Comments

                                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: cmp-1
                                                                                  TypeNarrative
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  260. Composition.section:sectionResults.mode
                                                                                  Definition

                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                  Shortworking | snapshot | changes
                                                                                  Comments

                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                  Control0..1
                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                  The processing mode that applies to this section.

                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  262. Composition.section:sectionResults.orderedBy
                                                                                  Definition

                                                                                  Specifies the order applied to the items in the section entries.

                                                                                  ShortOrder of section entries
                                                                                  Comments

                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                  Control0..1
                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                  What order applies to the items in the entry.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  264. Composition.section:sectionResults.entry
                                                                                  Definition

                                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                                  ShortA reference to data that supports this section
                                                                                  Comments

                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: cmp-2
                                                                                  TypeReference(Resource)
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  266. Composition.section:sectionResults.emptyReason
                                                                                  Definition

                                                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                  ShortWhy the section is empty
                                                                                  Comments

                                                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: cmp-2
                                                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                  If a section is empty, why it is empty.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  268. Composition.section:sectionResults.section
                                                                                  Definition

                                                                                  A nested sub-section within this section.

                                                                                  ShortNested Section
                                                                                  Comments

                                                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                  Control0..0
                                                                                  This element is affected by the following invariants: cmp-1
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  270. Composition.section:sectionProceduresHx
                                                                                  Slice NamesectionProceduresHx
                                                                                  Definition

                                                                                  DESC Procedures

                                                                                  ShortHistory of Procedures
                                                                                  Control0..1
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                  272. Composition.section:sectionProceduresHx.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
                                                                                  274. Composition.section:sectionProceduresHx.extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 276. Composition.section:sectionProceduresHx.extension:section-note
                                                                                    Slice Namesection-note
                                                                                    Definition

                                                                                    Additional notes that apply to the section (but not to specific resource).

                                                                                    ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                    Comments

                                                                                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                    Control0..*
                                                                                    TypeExtension(Note) (Extension Type: Annotation)
                                                                                    Is Modifierfalse
                                                                                    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())
                                                                                    278. Composition.section:sectionProceduresHx.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())
                                                                                    280. Composition.section:sectionProceduresHx.title
                                                                                    Definition

                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                    ShortLabel for section (e.g. for ToC)
                                                                                    Comments

                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                    Control1..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                    Alternate Namesheader, label, caption
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    282. Composition.section:sectionProceduresHx.code
                                                                                    Definition

                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                    ShortClassification of section (recommended)
                                                                                    Comments

                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                    Control1..1
                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                    Classification of a section of a composition/document.

                                                                                    TypeCodeableConcept(Codeable Concept (IPS))
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Provides computable standardized labels to topics within the document.

                                                                                    Pattern Value{
                                                                                      "coding" : [{
                                                                                        "system" : "http://loinc.org",
                                                                                        "code" : "47519-4"
                                                                                      }]
                                                                                    }
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    284. Composition.section:sectionProceduresHx.author
                                                                                    Definition

                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                    ShortWho and/or what authored the section
                                                                                    Control0..*
                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies who is responsible for the content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    286. Composition.section:sectionProceduresHx.focus
                                                                                    Definition

                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                    Comments

                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                    A human-readable narrative that contains the attested content of the section, 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.

                                                                                    ShortText summary of the section, for human interpretation
                                                                                    Comments

                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: cmp-1
                                                                                    TypeNarrative
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    290. Composition.section:sectionProceduresHx.mode
                                                                                    Definition

                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                    Shortworking | snapshot | changes
                                                                                    Comments

                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                    Control0..1
                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                    The processing mode that applies to this section.

                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    292. Composition.section:sectionProceduresHx.orderedBy
                                                                                    Definition

                                                                                    Specifies the order applied to the items in the section entries.

                                                                                    ShortOrder of section entries
                                                                                    Comments

                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                    Control0..1
                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                    What order applies to the items in the entry.

                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    294. Composition.section:sectionProceduresHx.entry
                                                                                    Definition

                                                                                    DESC Procedures

                                                                                    ShortPatient past procedures pertinent to the scope of this document.
                                                                                    Comments

                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: cmp-2
                                                                                    TypeReference(Procedure, DocumentReference)
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • type @ resolve()
                                                                                    • 296. Composition.section:sectionProceduresHx.entry:procedure
                                                                                      Slice Nameprocedure
                                                                                      Definition

                                                                                      It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.

                                                                                      ShortClinical problems or conditions currently being monitored for the patient.
                                                                                      Comments

                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: cmp-2
                                                                                      TypeReference(Procedure (EPS))
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      298. Composition.section:sectionProceduresHx.emptyReason
                                                                                      Definition

                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                      ShortWhy the section is empty
                                                                                      Comments

                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: cmp-2
                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                      If a section is empty, why it is empty.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      300. Composition.section:sectionProceduresHx.section
                                                                                      Definition

                                                                                      A nested sub-section within this section.

                                                                                      ShortNested Section
                                                                                      Comments

                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                      Control0..0
                                                                                      This element is affected by the following invariants: cmp-1
                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      302. Composition.section:sectionMedicalDevices
                                                                                      Slice NamesectionMedicalDevices
                                                                                      Definition

                                                                                      The medical devices section contains a narrative description of the medical devices used by the patient in the past. It includes entries for device use as described in related profiles

                                                                                      ShortMedical Devices
                                                                                      Control0..1
                                                                                      TypeBackboneElement
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                      304. Composition.section:sectionMedicalDevices.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
                                                                                      306. Composition.section:sectionMedicalDevices.extension
                                                                                      Definition

                                                                                      An Extension

                                                                                      ShortExtension
                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 308. Composition.section:sectionMedicalDevices.extension:section-note
                                                                                        Slice Namesection-note
                                                                                        Definition

                                                                                        Additional notes that apply to the section (but not to specific resource).

                                                                                        ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                        Comments

                                                                                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                        Control0..*
                                                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                                                        Is Modifierfalse
                                                                                        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())
                                                                                        310. Composition.section:sectionMedicalDevices.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())
                                                                                        312. Composition.section:sectionMedicalDevices.title
                                                                                        Definition

                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                        ShortLabel for section (e.g. for ToC)
                                                                                        Comments

                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                        Control1..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                        Alternate Namesheader, label, caption
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        314. Composition.section:sectionMedicalDevices.code
                                                                                        Definition

                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                        ShortClassification of section (recommended)
                                                                                        Comments

                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                        Control1..1
                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                        Classification of a section of a composition/document.

                                                                                        TypeCodeableConcept(Codeable Concept (IPS))
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Provides computable standardized labels to topics within the document.

                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://loinc.org",
                                                                                            "code" : "46264-8"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        316. Composition.section:sectionMedicalDevices.author
                                                                                        Definition

                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                        ShortWho and/or what authored the section
                                                                                        Control0..*
                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Identifies who is responsible for the content.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        318. Composition.section:sectionMedicalDevices.focus
                                                                                        Definition

                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                        Comments

                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                        A human-readable narrative that contains the attested content of the section, 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.

                                                                                        ShortText summary of the section, for human interpretation
                                                                                        Comments

                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: cmp-1
                                                                                        TypeNarrative
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        322. Composition.section:sectionMedicalDevices.mode
                                                                                        Definition

                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                        Shortworking | snapshot | changes
                                                                                        Comments

                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                        Control0..1
                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                        The processing mode that applies to this section.

                                                                                        Typecode
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        324. Composition.section:sectionMedicalDevices.orderedBy
                                                                                        Definition

                                                                                        Specifies the order applied to the items in the section entries.

                                                                                        ShortOrder of section entries
                                                                                        Comments

                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                        Control0..1
                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                        What order applies to the items in the entry.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        326. Composition.section:sectionMedicalDevices.entry
                                                                                        Definition

                                                                                        Med devices Description

                                                                                        ShortMed Device short
                                                                                        Comments

                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        TypeReference(Resource)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • type @ resolve()
                                                                                        • 328. Composition.section:sectionMedicalDevices.entry:deviceStatement
                                                                                          Slice NamedeviceStatement
                                                                                          Definition

                                                                                          DESCR deviceStatement

                                                                                          ShortSHORT deviceStatement
                                                                                          Comments

                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: cmp-2
                                                                                          TypeReference(DeviceUseStatement (EPS))
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          330. Composition.section:sectionMedicalDevices.emptyReason
                                                                                          Definition

                                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                          ShortWhy the section is empty
                                                                                          Comments

                                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: cmp-2
                                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                          If a section is empty, why it is empty.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          332. Composition.section:sectionMedicalDevices.section
                                                                                          Definition

                                                                                          A nested sub-section within this section.

                                                                                          ShortNested Section
                                                                                          Comments

                                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                          Control0..0
                                                                                          This element is affected by the following invariants: cmp-1
                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          334. Composition.section:sectionAdvanceDirectives
                                                                                          Slice NamesectionAdvanceDirectives
                                                                                          Definition

                                                                                          The advance directives section contains a narrative description of patient's advance directive.

                                                                                          ShortAdvance Directives Section
                                                                                          Control0..1
                                                                                          TypeBackboneElement
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                          336. Composition.section:sectionAdvanceDirectives.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
                                                                                          338. Composition.section:sectionAdvanceDirectives.extension
                                                                                          Definition

                                                                                          An Extension

                                                                                          ShortExtension
                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifierfalse
                                                                                          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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 340. Composition.section:sectionAdvanceDirectives.extension:section-note
                                                                                            Slice Namesection-note
                                                                                            Definition

                                                                                            Additional notes that apply to the section (but not to specific resource).

                                                                                            ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                            Comments

                                                                                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                            Control0..*
                                                                                            TypeExtension(Note) (Extension Type: Annotation)
                                                                                            Is Modifierfalse
                                                                                            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())
                                                                                            342. Composition.section:sectionAdvanceDirectives.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())
                                                                                            344. Composition.section:sectionAdvanceDirectives.title
                                                                                            Definition

                                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                            ShortLabel for section (e.g. for ToC)
                                                                                            Comments

                                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                            Control1..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                            Alternate Namesheader, label, caption
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            346. Composition.section:sectionAdvanceDirectives.code
                                                                                            Definition

                                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                            ShortClassification of section (recommended)
                                                                                            Comments

                                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                            Control1..1
                                                                                            BindingFor example codes, see DocumentSectionCodes
                                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                            Classification of a section of a composition/document.

                                                                                            TypeCodeableConcept(Codeable Concept (IPS))
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Provides computable standardized labels to topics within the document.

                                                                                            Pattern Value{
                                                                                              "coding" : [{
                                                                                                "system" : "http://loinc.org",
                                                                                                "code" : "42348-3"
                                                                                              }]
                                                                                            }
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            348. Composition.section:sectionAdvanceDirectives.author
                                                                                            Definition

                                                                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                            ShortWho and/or what authored the section
                                                                                            Control0..*
                                                                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Identifies who is responsible for the content.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            350. Composition.section:sectionAdvanceDirectives.focus
                                                                                            Definition

                                                                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                            ShortWho/what the section is about, when it is not about the subject of composition
                                                                                            Comments

                                                                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                            A human-readable narrative that contains the attested content of the section, 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.

                                                                                            ShortText summary of the section, for human interpretation
                                                                                            Comments

                                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: cmp-1
                                                                                            TypeNarrative
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            354. Composition.section:sectionAdvanceDirectives.mode
                                                                                            Definition

                                                                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                            Shortworking | snapshot | changes
                                                                                            Comments

                                                                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                            Control0..1
                                                                                            BindingThe codes SHALL be taken from ListMode
                                                                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                            The processing mode that applies to this section.

                                                                                            Typecode
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            356. Composition.section:sectionAdvanceDirectives.orderedBy
                                                                                            Definition

                                                                                            Specifies the order applied to the items in the section entries.

                                                                                            ShortOrder of section entries
                                                                                            Comments

                                                                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                            Control0..1
                                                                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                            What order applies to the items in the entry.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            358. Composition.section:sectionAdvanceDirectives.entry
                                                                                            Definition

                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                            ShortA reference to data that supports this section
                                                                                            Comments

                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: cmp-2
                                                                                            TypeReference(Consent (Advance Directives EPS), DocumentReference)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            360. Composition.section:sectionAdvanceDirectives.emptyReason
                                                                                            Definition

                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                            ShortWhy the section is empty
                                                                                            Comments

                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: cmp-2
                                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                            If a section is empty, why it is empty.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            362. Composition.section:sectionAdvanceDirectives.section
                                                                                            Definition

                                                                                            A nested sub-section within this section.

                                                                                            ShortNested Section
                                                                                            Comments

                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                            Control0..0
                                                                                            This element is affected by the following invariants: cmp-1
                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            364. Composition.section:sectionAlerts
                                                                                            Slice NamesectionAlerts
                                                                                            Definition

                                                                                            The root of the sections that make up the composition.

                                                                                            ShortComposition is broken into sections
                                                                                            Control0..1
                                                                                            TypeBackboneElement
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            366. Composition.section:sectionAlerts.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
                                                                                            368. Composition.section:sectionAlerts.extension
                                                                                            Definition

                                                                                            An Extension

                                                                                            ShortExtension
                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            Is Modifierfalse
                                                                                            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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 370. Composition.section:sectionAlerts.extension:section-note
                                                                                              Slice Namesection-note
                                                                                              Definition

                                                                                              Additional notes that apply to the section (but not to specific resource).

                                                                                              ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                              Comments

                                                                                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                              Control0..*
                                                                                              TypeExtension(Note) (Extension Type: Annotation)
                                                                                              Is Modifierfalse
                                                                                              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())
                                                                                              372. Composition.section:sectionAlerts.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())
                                                                                              374. Composition.section:sectionAlerts.title
                                                                                              Definition

                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                              Comments

                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                              Control1..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                              Alternate Namesheader, label, caption
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              376. Composition.section:sectionAlerts.code
                                                                                              Definition

                                                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                              ShortClassification of section (recommended)
                                                                                              Comments

                                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                              Control1..1
                                                                                              BindingFor example codes, see DocumentSectionCodes
                                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                              Classification of a section of a composition/document.

                                                                                              TypeCodeableConcept
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Provides computable standardized labels to topics within the document.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              378. Composition.section:sectionAlerts.author
                                                                                              Definition

                                                                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                              ShortWho and/or what authored the section
                                                                                              Control0..*
                                                                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Identifies who is responsible for the content.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              380. Composition.section:sectionAlerts.focus
                                                                                              Definition

                                                                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                              ShortWho/what the section is about, when it is not about the subject of composition
                                                                                              Comments

                                                                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                              A human-readable narrative that contains the attested content of the section, 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.

                                                                                              ShortText summary of the section, for human interpretation
                                                                                              Comments

                                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: cmp-1
                                                                                              TypeNarrative
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              384. Composition.section:sectionAlerts.mode
                                                                                              Definition

                                                                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                              Shortworking | snapshot | changes
                                                                                              Comments

                                                                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                              Control0..1
                                                                                              BindingThe codes SHALL be taken from ListMode
                                                                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                              The processing mode that applies to this section.

                                                                                              Typecode
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              386. Composition.section:sectionAlerts.orderedBy
                                                                                              Definition

                                                                                              Specifies the order applied to the items in the section entries.

                                                                                              ShortOrder of section entries
                                                                                              Comments

                                                                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                              Control0..1
                                                                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                              What order applies to the items in the entry.

                                                                                              TypeCodeableConcept
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              388. Composition.section:sectionAlerts.entry
                                                                                              Definition

                                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                                              ShortA reference to data that supports this section
                                                                                              Comments

                                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: cmp-2
                                                                                              TypeReference(Resource)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              390. Composition.section:sectionAlerts.emptyReason
                                                                                              Definition

                                                                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                              ShortWhy the section is empty
                                                                                              Comments

                                                                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: cmp-2
                                                                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                              If a section is empty, why it is empty.

                                                                                              TypeCodeableConcept
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              392. Composition.section:sectionAlerts.section
                                                                                              Definition

                                                                                              A nested sub-section within this section.

                                                                                              ShortNested Section
                                                                                              Comments

                                                                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                              Control0..0
                                                                                              This element is affected by the following invariants: cmp-1
                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              394. Composition.section:sectionFunctionalStatus
                                                                                              Slice NamesectionFunctionalStatus
                                                                                              Definition

                                                                                              The functional status section contains a narrative description of the patient's functional status. It includes entries for functional status as described in related profiles

                                                                                              ShortFunctional Status
                                                                                              Control0..1
                                                                                              TypeBackboneElement
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                              396. Composition.section:sectionFunctionalStatus.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
                                                                                              398. Composition.section:sectionFunctionalStatus.extension
                                                                                              Definition

                                                                                              An Extension

                                                                                              ShortExtension
                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifierfalse
                                                                                              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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 400. Composition.section:sectionFunctionalStatus.extension:section-note
                                                                                                Slice Namesection-note
                                                                                                Definition

                                                                                                Additional notes that apply to the section (but not to specific resource).

                                                                                                ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                Comments

                                                                                                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                Control0..*
                                                                                                TypeExtension(Note) (Extension Type: Annotation)
                                                                                                Is Modifierfalse
                                                                                                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())
                                                                                                402. Composition.section:sectionFunctionalStatus.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())
                                                                                                404. Composition.section:sectionFunctionalStatus.title
                                                                                                Definition

                                                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                ShortLabel for section (e.g. for ToC)
                                                                                                Comments

                                                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                Control1..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                Alternate Namesheader, label, caption
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                406. Composition.section:sectionFunctionalStatus.code
                                                                                                Definition

                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                ShortClassification of section (recommended)
                                                                                                Comments

                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                Control1..1
                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                Classification of a section of a composition/document.

                                                                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                Pattern Value{
                                                                                                  "coding" : [{
                                                                                                    "system" : "http://loinc.org",
                                                                                                    "code" : "47420-5"
                                                                                                  }]
                                                                                                }
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                408. Composition.section:sectionFunctionalStatus.author
                                                                                                Definition

                                                                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                ShortWho and/or what authored the section
                                                                                                Control0..*
                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Identifies who is responsible for the content.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                410. Composition.section:sectionFunctionalStatus.focus
                                                                                                Definition

                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                Comments

                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                A human-readable narrative that contains the attested content of the section, 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.

                                                                                                ShortText summary of the section, for human interpretation
                                                                                                Comments

                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                TypeNarrative
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                414. Composition.section:sectionFunctionalStatus.mode
                                                                                                Definition

                                                                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                Shortworking | snapshot | changes
                                                                                                Comments

                                                                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                Control0..1
                                                                                                BindingThe codes SHALL be taken from ListMode
                                                                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                The processing mode that applies to this section.

                                                                                                Typecode
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                416. Composition.section:sectionFunctionalStatus.orderedBy
                                                                                                Definition

                                                                                                Specifies the order applied to the items in the section entries.

                                                                                                ShortOrder of section entries
                                                                                                Comments

                                                                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                Control0..1
                                                                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                What order applies to the items in the entry.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                418. Composition.section:sectionFunctionalStatus.entry
                                                                                                Definition

                                                                                                Functional Status Description

                                                                                                ShortFunctional Status short
                                                                                                Comments

                                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                TypeReference(Resource)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • type @ resolve()
                                                                                                • 420. Composition.section:sectionFunctionalStatus.entry:functionalStatus
                                                                                                  Slice NamefunctionalStatus
                                                                                                  Definition

                                                                                                  DESCR functionalStatus

                                                                                                  ShortSHORT functionalStatus
                                                                                                  Comments

                                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                  TypeReference(Condition (EPS))
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  422. Composition.section:sectionFunctionalStatus.emptyReason
                                                                                                  Definition

                                                                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                  ShortWhy the section is empty
                                                                                                  Comments

                                                                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                  If a section is empty, why it is empty.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  424. Composition.section:sectionFunctionalStatus.section
                                                                                                  Definition

                                                                                                  A nested sub-section within this section.

                                                                                                  ShortNested Section
                                                                                                  Comments

                                                                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                  Control0..0
                                                                                                  This element is affected by the following invariants: cmp-1
                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  426. Composition.section:sectionPastProblems
                                                                                                  Slice NamesectionPastProblems
                                                                                                  Definition

                                                                                                  The past problems section contains a narrative description of the patient's past problems. It includes entries for problems as described in related profiles

                                                                                                  ShortPast Problems
                                                                                                  Control0..1
                                                                                                  TypeBackboneElement
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                                  428. Composition.section:sectionPastProblems.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
                                                                                                  430. Composition.section:sectionPastProblems.extension
                                                                                                  Definition

                                                                                                  An Extension

                                                                                                  ShortExtension
                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 432. Composition.section:sectionPastProblems.extension:section-note
                                                                                                    Slice Namesection-note
                                                                                                    Definition

                                                                                                    Additional notes that apply to the section (but not to specific resource).

                                                                                                    ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                    Comments

                                                                                                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                    Control0..*
                                                                                                    TypeExtension(Note) (Extension Type: Annotation)
                                                                                                    Is Modifierfalse
                                                                                                    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())
                                                                                                    434. Composition.section:sectionPastProblems.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())
                                                                                                    436. Composition.section:sectionPastProblems.title
                                                                                                    Definition

                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                    ShortLabel for section (e.g. for ToC)
                                                                                                    Comments

                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                    Alternate Namesheader, label, caption
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    438. Composition.section:sectionPastProblems.code
                                                                                                    Definition

                                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                    ShortClassification of section (recommended)
                                                                                                    Comments

                                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                    Control1..1
                                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                    Classification of a section of a composition/document.

                                                                                                    TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "8716-3"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    440. Composition.section:sectionPastProblems.author
                                                                                                    Definition

                                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                    ShortWho and/or what authored the section
                                                                                                    Control0..*
                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Identifies who is responsible for the content.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    442. Composition.section:sectionPastProblems.focus
                                                                                                    Definition

                                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                    Comments

                                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                    A human-readable narrative that contains the attested content of the section, 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.

                                                                                                    ShortText summary of the section, for human interpretation
                                                                                                    Comments

                                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeNarrative
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    446. Composition.section:sectionPastProblems.mode
                                                                                                    Definition

                                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                    Shortworking | snapshot | changes
                                                                                                    Comments

                                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                    The processing mode that applies to this section.

                                                                                                    Typecode
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    448. Composition.section:sectionPastProblems.orderedBy
                                                                                                    Definition

                                                                                                    Specifies the order applied to the items in the section entries.

                                                                                                    ShortOrder of section entries
                                                                                                    Comments

                                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                    What order applies to the items in the entry.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    450. Composition.section:sectionPastProblems.entry
                                                                                                    Definition

                                                                                                    Past Problems Description

                                                                                                    ShortPast Problems short
                                                                                                    Comments

                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • type @ resolve()
                                                                                                    • 452. Composition.section:sectionPastProblems.entry:pastProblem
                                                                                                      Slice NamepastProblem
                                                                                                      Definition

                                                                                                      DESCR pastProblem

                                                                                                      ShortSHORT pastProblem
                                                                                                      Comments

                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                      TypeReference(Condition (EPS))
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      454. Composition.section:sectionPastProblems.emptyReason
                                                                                                      Definition

                                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                      ShortWhy the section is empty
                                                                                                      Comments

                                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                      If a section is empty, why it is empty.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      456. Composition.section:sectionPastProblems.section
                                                                                                      Definition

                                                                                                      A nested sub-section within this section.

                                                                                                      ShortNested Section
                                                                                                      Comments

                                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                      Control0..0
                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      458. Composition.section:sectionPregnancyHx
                                                                                                      Slice NamesectionPregnancyHx
                                                                                                      Definition

                                                                                                      The pregnancy history section contains a narrative description of the patient's pregnancy history. It includes entries for pregnancy history as described in related profiles

                                                                                                      ShortPregnancy History
                                                                                                      Control0..1
                                                                                                      TypeBackboneElement
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                                      460. Composition.section:sectionPregnancyHx.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
                                                                                                      462. Composition.section:sectionPregnancyHx.extension
                                                                                                      Definition

                                                                                                      An Extension

                                                                                                      ShortExtension
                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifierfalse
                                                                                                      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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 464. Composition.section:sectionPregnancyHx.extension:section-note
                                                                                                        Slice Namesection-note
                                                                                                        Definition

                                                                                                        Additional notes that apply to the section (but not to specific resource).

                                                                                                        ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                        Comments

                                                                                                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                        Control0..*
                                                                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                                                                        Is Modifierfalse
                                                                                                        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())
                                                                                                        466. Composition.section:sectionPregnancyHx.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())
                                                                                                        468. Composition.section:sectionPregnancyHx.title
                                                                                                        Definition

                                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                        ShortLabel for section (e.g. for ToC)
                                                                                                        Comments

                                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                        Control1..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                        Alternate Namesheader, label, caption
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        470. Composition.section:sectionPregnancyHx.code
                                                                                                        Definition

                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                        ShortClassification of section (recommended)
                                                                                                        Comments

                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                        Control1..1
                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                        Classification of a section of a composition/document.

                                                                                                        TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://loinc.org",
                                                                                                            "code" : "10162-6"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        472. Composition.section:sectionPregnancyHx.author
                                                                                                        Definition

                                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                        ShortWho and/or what authored the section
                                                                                                        Control0..*
                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Identifies who is responsible for the content.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        474. Composition.section:sectionPregnancyHx.focus
                                                                                                        Definition

                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                        Comments

                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                        A human-readable narrative that contains the attested content of the section, 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.

                                                                                                        ShortText summary of the section, for human interpretation
                                                                                                        Comments

                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                        TypeNarrative
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        478. Composition.section:sectionPregnancyHx.mode
                                                                                                        Definition

                                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                        Shortworking | snapshot | changes
                                                                                                        Comments

                                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                        The processing mode that applies to this section.

                                                                                                        Typecode
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        480. Composition.section:sectionPregnancyHx.orderedBy
                                                                                                        Definition

                                                                                                        Specifies the order applied to the items in the section entries.

                                                                                                        ShortOrder of section entries
                                                                                                        Comments

                                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                        What order applies to the items in the entry.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        482. Composition.section:sectionPregnancyHx.entry
                                                                                                        Definition

                                                                                                        Pregnancy History Description

                                                                                                        ShortPregnancy History short
                                                                                                        Comments

                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                        TypeReference(Resource)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • type @ resolve()
                                                                                                        • 484. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
                                                                                                          Slice NamepregnancyStatus
                                                                                                          Definition

                                                                                                          DESCR Pregnancy status

                                                                                                          ShortPregnancy status
                                                                                                          Comments

                                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                          TypeReference(Observation Pregnancy - Status (IPS))
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          486. Composition.section:sectionPregnancyHx.entry:pregnancyOutcome
                                                                                                          Slice NamepregnancyOutcome
                                                                                                          Definition

                                                                                                          DESCR Pregnancy outcome

                                                                                                          ShortPregnancy outcome
                                                                                                          Comments

                                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                          TypeReference(Observation Pregnancy - Outcome (IPS))
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          488. Composition.section:sectionPregnancyHx.emptyReason
                                                                                                          Definition

                                                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                          ShortWhy the section is empty
                                                                                                          Comments

                                                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                          If a section is empty, why it is empty.

                                                                                                          TypeCodeableConcept
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          490. Composition.section:sectionPregnancyHx.section
                                                                                                          Definition

                                                                                                          A nested sub-section within this section.

                                                                                                          ShortNested Section
                                                                                                          Comments

                                                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                          Control0..0
                                                                                                          This element is affected by the following invariants: cmp-1
                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          492. Composition.section:sectionPatientStory
                                                                                                          Slice NamesectionPatientStory
                                                                                                          Definition

                                                                                                          The root of the sections that make up the composition.

                                                                                                          ShortComposition is broken into sections
                                                                                                          Control0..1
                                                                                                          TypeBackboneElement
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          494. Composition.section:sectionPatientStory.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
                                                                                                          496. Composition.section:sectionPatientStory.extension
                                                                                                          Definition

                                                                                                          An Extension

                                                                                                          ShortExtension
                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 498. Composition.section:sectionPatientStory.extension:section-note
                                                                                                            Slice Namesection-note
                                                                                                            Definition

                                                                                                            Additional notes that apply to the section (but not to specific resource).

                                                                                                            ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                            Comments

                                                                                                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                            Control0..*
                                                                                                            TypeExtension(Note) (Extension Type: Annotation)
                                                                                                            Is Modifierfalse
                                                                                                            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())
                                                                                                            500. Composition.section:sectionPatientStory.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())
                                                                                                            502. Composition.section:sectionPatientStory.title
                                                                                                            Definition

                                                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                            ShortLabel for section (e.g. for ToC)
                                                                                                            Comments

                                                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                            Control1..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                            Alternate Namesheader, label, caption
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            504. Composition.section:sectionPatientStory.code
                                                                                                            Definition

                                                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                            ShortClassification of section (recommended)
                                                                                                            Comments

                                                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                            Control1..1
                                                                                                            BindingFor example codes, see DocumentSectionCodes
                                                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                            Classification of a section of a composition/document.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Provides computable standardized labels to topics within the document.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            506. Composition.section:sectionPatientStory.author
                                                                                                            Definition

                                                                                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                            ShortWho and/or what authored the section
                                                                                                            Control0..*
                                                                                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Identifies who is responsible for the content.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            508. Composition.section:sectionPatientStory.focus
                                                                                                            Definition

                                                                                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                            ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                            Comments

                                                                                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                            A human-readable narrative that contains the attested content of the section, 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.

                                                                                                            ShortText summary of the section, for human interpretation
                                                                                                            Comments

                                                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                            TypeNarrative
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            512. Composition.section:sectionPatientStory.mode
                                                                                                            Definition

                                                                                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                            Shortworking | snapshot | changes
                                                                                                            Comments

                                                                                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                            Control0..1
                                                                                                            BindingThe codes SHALL be taken from ListMode
                                                                                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                            The processing mode that applies to this section.

                                                                                                            Typecode
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            514. Composition.section:sectionPatientStory.orderedBy
                                                                                                            Definition

                                                                                                            Specifies the order applied to the items in the section entries.

                                                                                                            ShortOrder of section entries
                                                                                                            Comments

                                                                                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                            Control0..1
                                                                                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                            What order applies to the items in the entry.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            516. Composition.section:sectionPatientStory.entry
                                                                                                            Definition

                                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                                            ShortA reference to data that supports this section
                                                                                                            Comments

                                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                            TypeReference(Resource)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            518. Composition.section:sectionPatientStory.emptyReason
                                                                                                            Definition

                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                            ShortWhy the section is empty
                                                                                                            Comments

                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                            If a section is empty, why it is empty.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            520. Composition.section:sectionPatientStory.section
                                                                                                            Definition

                                                                                                            A nested sub-section within this section.

                                                                                                            ShortNested Section
                                                                                                            Comments

                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                            Control0..0
                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            522. Composition.section:sectionPlanOfCare
                                                                                                            Slice NamesectionPlanOfCare
                                                                                                            Definition

                                                                                                            The health maintenance care plan section contains a description of the expectations for wellness care including proposals, goals, and order requests for monitoring, tracking, or improving the lifetime condition of the patient with goals of educating the patient on how to reduce the modifiable risks of the patient\’s genetic, behavioral, and environmental pre-conditions and otherwise optimizing lifetime outcomes.

                                                                                                            ShortHealth Maintenance Care Plan
                                                                                                            Control0..1
                                                                                                            TypeBackboneElement
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            524. Composition.section:sectionPlanOfCare.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
                                                                                                            526. Composition.section:sectionPlanOfCare.extension
                                                                                                            Definition

                                                                                                            An Extension

                                                                                                            ShortExtension
                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifierfalse
                                                                                                            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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 528. Composition.section:sectionPlanOfCare.extension:section-note
                                                                                                              Slice Namesection-note
                                                                                                              Definition

                                                                                                              Additional notes that apply to the section (but not to specific resource).

                                                                                                              ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                              Comments

                                                                                                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                              Control0..*
                                                                                                              TypeExtension(Note) (Extension Type: Annotation)
                                                                                                              Is Modifierfalse
                                                                                                              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())
                                                                                                              530. Composition.section:sectionPlanOfCare.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())
                                                                                                              532. Composition.section:sectionPlanOfCare.title
                                                                                                              Definition

                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                                              Comments

                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                              Control1..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                              Alternate Namesheader, label, caption
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              534. Composition.section:sectionPlanOfCare.code
                                                                                                              Definition

                                                                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                              ShortClassification of section (recommended)
                                                                                                              Comments

                                                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                              Control1..1
                                                                                                              BindingFor example codes, see DocumentSectionCodes
                                                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                              Classification of a section of a composition/document.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Provides computable standardized labels to topics within the document.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              536. Composition.section:sectionPlanOfCare.author
                                                                                                              Definition

                                                                                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                              ShortWho and/or what authored the section
                                                                                                              Control0..*
                                                                                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Identifies who is responsible for the content.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              538. Composition.section:sectionPlanOfCare.focus
                                                                                                              Definition

                                                                                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                              ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                              Comments

                                                                                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                              A human-readable narrative that contains the attested content of the section, 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.

                                                                                                              ShortText summary of the section, for human interpretation
                                                                                                              Comments

                                                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: cmp-1
                                                                                                              TypeNarrative
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              542. Composition.section:sectionPlanOfCare.mode
                                                                                                              Definition

                                                                                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                              Shortworking | snapshot | changes
                                                                                                              Comments

                                                                                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                              Control0..1
                                                                                                              BindingThe codes SHALL be taken from ListMode
                                                                                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                              The processing mode that applies to this section.

                                                                                                              Typecode
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              544. Composition.section:sectionPlanOfCare.orderedBy
                                                                                                              Definition

                                                                                                              Specifies the order applied to the items in the section entries.

                                                                                                              ShortOrder of section entries
                                                                                                              Comments

                                                                                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                              Control0..1
                                                                                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                              What order applies to the items in the entry.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              546. Composition.section:sectionPlanOfCare.entry
                                                                                                              Definition

                                                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                                                              ShortA reference to data that supports this section
                                                                                                              Comments

                                                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: cmp-2
                                                                                                              TypeReference(Resource)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              548. Composition.section:sectionPlanOfCare.emptyReason
                                                                                                              Definition

                                                                                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                              ShortWhy the section is empty
                                                                                                              Comments

                                                                                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: cmp-2
                                                                                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                              If a section is empty, why it is empty.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              550. Composition.section:sectionPlanOfCare.section
                                                                                                              Definition

                                                                                                              A nested sub-section within this section.

                                                                                                              ShortNested Section
                                                                                                              Comments

                                                                                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                              Control0..0
                                                                                                              This element is affected by the following invariants: cmp-1
                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              552. Composition.section:sectionSocialHistory
                                                                                                              Slice NamesectionSocialHistory
                                                                                                              Definition

                                                                                                              The social history section contains a narrative description of the person\’s beliefs, home life, community life, work life, hobbies, and risky habits. It includes Social History Observations.

                                                                                                              ShortSocial History
                                                                                                              Control0..1
                                                                                                              TypeBackboneElement
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              554. Composition.section:sectionSocialHistory.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
                                                                                                              556. Composition.section:sectionSocialHistory.extension
                                                                                                              Definition

                                                                                                              An Extension

                                                                                                              ShortExtension
                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 558. Composition.section:sectionSocialHistory.extension:section-note
                                                                                                                Slice Namesection-note
                                                                                                                Definition

                                                                                                                Additional notes that apply to the section (but not to specific resource).

                                                                                                                ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                                Comments

                                                                                                                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                Control0..*
                                                                                                                TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                Is Modifierfalse
                                                                                                                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())
                                                                                                                560. Composition.section:sectionSocialHistory.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())
                                                                                                                562. Composition.section:sectionSocialHistory.title
                                                                                                                Definition

                                                                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                ShortLabel for section (e.g. for ToC)
                                                                                                                Comments

                                                                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                Control1..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                Alternate Namesheader, label, caption
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                564. Composition.section:sectionSocialHistory.code
                                                                                                                Definition

                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                ShortClassification of section (recommended)
                                                                                                                Comments

                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                Control1..1
                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                                Classification of a section of a composition/document.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                566. Composition.section:sectionSocialHistory.author
                                                                                                                Definition

                                                                                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                ShortWho and/or what authored the section
                                                                                                                Control0..*
                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Identifies who is responsible for the content.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                568. Composition.section:sectionSocialHistory.focus
                                                                                                                Definition

                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                Comments

                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                                A human-readable narrative that contains the attested content of the section, 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.

                                                                                                                ShortText summary of the section, for human interpretation
                                                                                                                Comments

                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                Control1..1
                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                TypeNarrative
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                572. Composition.section:sectionSocialHistory.mode
                                                                                                                Definition

                                                                                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                Shortworking | snapshot | changes
                                                                                                                Comments

                                                                                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                Control0..1
                                                                                                                BindingThe codes SHALL be taken from ListMode
                                                                                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                The processing mode that applies to this section.

                                                                                                                Typecode
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                574. Composition.section:sectionSocialHistory.orderedBy
                                                                                                                Definition

                                                                                                                Specifies the order applied to the items in the section entries.

                                                                                                                ShortOrder of section entries
                                                                                                                Comments

                                                                                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                Control0..1
                                                                                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                                What order applies to the items in the entry.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                576. Composition.section:sectionSocialHistory.entry
                                                                                                                Definition

                                                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                ShortA reference to data that supports this section
                                                                                                                Comments

                                                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                                TypeReference(Resource)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                578. Composition.section:sectionSocialHistory.emptyReason
                                                                                                                Definition

                                                                                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                ShortWhy the section is empty
                                                                                                                Comments

                                                                                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                                If a section is empty, why it is empty.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                580. Composition.section:sectionSocialHistory.section
                                                                                                                Definition

                                                                                                                A nested sub-section within this section.

                                                                                                                ShortNested Section
                                                                                                                Comments

                                                                                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                Control0..0
                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                582. Composition.section:sectionVitalSigns
                                                                                                                Slice NamesectionVitalSigns
                                                                                                                Definition

                                                                                                                The vital signs section contains a narrative description of the patient's vital signs. It includes entries for vital sign measurements as described in related profiles

                                                                                                                ShortVital Signs
                                                                                                                Control0..1
                                                                                                                TypeBackboneElement
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                                                584. Composition.section:sectionVitalSigns.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
                                                                                                                586. Composition.section:sectionVitalSigns.extension
                                                                                                                Definition

                                                                                                                An Extension

                                                                                                                ShortExtension
                                                                                                                Control0..*
                                                                                                                TypeExtension
                                                                                                                Is Modifierfalse
                                                                                                                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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 588. Composition.section:sectionVitalSigns.extension:section-note
                                                                                                                  Slice Namesection-note
                                                                                                                  Definition

                                                                                                                  Additional notes that apply to the section (but not to specific resource).

                                                                                                                  ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                                  Comments

                                                                                                                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                  Control0..*
                                                                                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                  Is Modifierfalse
                                                                                                                  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())
                                                                                                                  590. Composition.section:sectionVitalSigns.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())
                                                                                                                  592. Composition.section:sectionVitalSigns.title
                                                                                                                  Definition

                                                                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                  ShortLabel for section (e.g. for ToC)
                                                                                                                  Comments

                                                                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                  Control1..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                  Alternate Namesheader, label, caption
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  594. Composition.section:sectionVitalSigns.code
                                                                                                                  Definition

                                                                                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                  ShortClassification of section (recommended)
                                                                                                                  Comments

                                                                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                  Control1..1
                                                                                                                  BindingFor example codes, see DocumentSectionCodes
                                                                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                                  Classification of a section of a composition/document.

                                                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Provides computable standardized labels to topics within the document.

                                                                                                                  Pattern Value{
                                                                                                                    "coding" : [{
                                                                                                                      "system" : "http://loinc.org",
                                                                                                                      "code" : "8716-3"
                                                                                                                    }]
                                                                                                                  }
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  596. Composition.section:sectionVitalSigns.author
                                                                                                                  Definition

                                                                                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                  ShortWho and/or what authored the section
                                                                                                                  Control0..*
                                                                                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Identifies who is responsible for the content.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  598. Composition.section:sectionVitalSigns.focus
                                                                                                                  Definition

                                                                                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                  Comments

                                                                                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                                                                                  ShortText summary of the section, for human interpretation
                                                                                                                  Comments

                                                                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                  Control1..1
                                                                                                                  This element is affected by the following invariants: cmp-1
                                                                                                                  TypeNarrative
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  602. Composition.section:sectionVitalSigns.mode
                                                                                                                  Definition

                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                  Shortworking | snapshot | changes
                                                                                                                  Comments

                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                  Control0..1
                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                  The processing mode that applies to this section.

                                                                                                                  Typecode
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  604. Composition.section:sectionVitalSigns.orderedBy
                                                                                                                  Definition

                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                  ShortOrder of section entries
                                                                                                                  Comments

                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                  Control0..1
                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                                  What order applies to the items in the entry.

                                                                                                                  TypeCodeableConcept
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  606. Composition.section:sectionVitalSigns.entry
                                                                                                                  Definition

                                                                                                                  Vital Signs Description

                                                                                                                  ShortVital Signs short
                                                                                                                  Comments

                                                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                  TypeReference(Resource)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • type @ resolve()
                                                                                                                  • 608. Composition.section:sectionVitalSigns.entry:vitalSign
                                                                                                                    Slice NamevitalSign
                                                                                                                    Definition

                                                                                                                    DESCR vitalSign

                                                                                                                    ShortSHORT vitalSign
                                                                                                                    Comments

                                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                    TypeReference(Vital Signs Profile)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    610. Composition.section:sectionVitalSigns.emptyReason
                                                                                                                    Definition

                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                    ShortWhy the section is empty
                                                                                                                    Comments

                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                                    If a section is empty, why it is empty.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    612. Composition.section:sectionVitalSigns.section
                                                                                                                    Definition

                                                                                                                    A nested sub-section within this section.

                                                                                                                    ShortNested Section
                                                                                                                    Comments

                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                    Control0..0
                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    614. Composition.section:sectionAlert
                                                                                                                    Slice NamesectionAlert
                                                                                                                    Definition

                                                                                                                    Information used to warn or call to a state of preparedness. Information flagged or intended to raise awareness of a potential danger to from the subject of the IPS or to from another individual or awareness of a potential obstacle to care.

                                                                                                                    ShortAlerts Section
                                                                                                                    Control0..1
                                                                                                                    TypeBackboneElement
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                                                    616. Composition.section:sectionAlert.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
                                                                                                                    618. Composition.section:sectionAlert.extension
                                                                                                                    Definition

                                                                                                                    An Extension

                                                                                                                    ShortExtension
                                                                                                                    Control0..*
                                                                                                                    TypeExtension
                                                                                                                    Is Modifierfalse
                                                                                                                    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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 620. Composition.section:sectionAlert.extension:section-note
                                                                                                                      Slice Namesection-note
                                                                                                                      Definition

                                                                                                                      Additional notes that apply to the section (but not to specific resource).

                                                                                                                      ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                                      Comments

                                                                                                                      This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                      Control0..*
                                                                                                                      TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                      Is Modifierfalse
                                                                                                                      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())
                                                                                                                      622. Composition.section:sectionAlert.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())
                                                                                                                      624. Composition.section:sectionAlert.title
                                                                                                                      Definition

                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                      ShortLabel for section (e.g. for ToC)
                                                                                                                      Comments

                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                      Alternate Namesheader, label, caption
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      626. Composition.section:sectionAlert.code
                                                                                                                      Definition

                                                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                      ShortClassification of section (recommended)
                                                                                                                      Comments

                                                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                      Control1..1
                                                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                                      Classification of a section of a composition/document.

                                                                                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Provides computable standardized labels to topics within the document.

                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "104605-1"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      628. Composition.section:sectionAlert.author
                                                                                                                      Definition

                                                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                      ShortWho and/or what authored the section
                                                                                                                      Control0..*
                                                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Identifies who is responsible for the content.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      630. Composition.section:sectionAlert.focus
                                                                                                                      Definition

                                                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                      Comments

                                                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                                      A human-readable narrative that contains the attested content of the section, 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.

                                                                                                                      ShortText summary of the section, for human interpretation
                                                                                                                      Comments

                                                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                      Control1..1
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeNarrative
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      634. Composition.section:sectionAlert.mode
                                                                                                                      Definition

                                                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                      Shortworking | snapshot | changes
                                                                                                                      Comments

                                                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                      The processing mode that applies to this section.

                                                                                                                      Typecode
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      636. Composition.section:sectionAlert.orderedBy
                                                                                                                      Definition

                                                                                                                      Specifies the order applied to the items in the section entries.

                                                                                                                      ShortOrder of section entries
                                                                                                                      Comments

                                                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                                      What order applies to the items in the entry.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      638. Composition.section:sectionAlert.entry
                                                                                                                      Definition

                                                                                                                      Alerts

                                                                                                                      ShortAlerts
                                                                                                                      Comments

                                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • type @ resolve()
                                                                                                                      • 640. Composition.section:sectionAlert.entry:flag
                                                                                                                        Slice Nameflag
                                                                                                                        Definition

                                                                                                                        Flags

                                                                                                                        ShortFlags
                                                                                                                        Comments

                                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                                        TypeReference(Flag (EU core) [WIP])
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        642. Composition.section:sectionAlert.emptyReason
                                                                                                                        Definition

                                                                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                        ShortWhy the section is empty
                                                                                                                        Comments

                                                                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                                        If a section is empty, why it is empty.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        644. Composition.section:sectionAlert.section
                                                                                                                        Definition

                                                                                                                        A nested sub-section within this section.

                                                                                                                        ShortNested Section
                                                                                                                        Comments

                                                                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                        Control0..0
                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        646. Composition.section:sectionTravelHx
                                                                                                                        Slice NamesectionTravelHx
                                                                                                                        Definition

                                                                                                                        This Section describes the travel history relevant for the Patient Summary, e.g.recent travel in a region of high prevalence of a specific infectious disease like Malaria

                                                                                                                        ShortTravel History Section
                                                                                                                        Control0..1
                                                                                                                        TypeBackboneElement
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                                                        648. Composition.section:sectionTravelHx.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
                                                                                                                        650. Composition.section:sectionTravelHx.extension
                                                                                                                        Definition

                                                                                                                        An Extension

                                                                                                                        ShortExtension
                                                                                                                        Control0..*
                                                                                                                        TypeExtension
                                                                                                                        Is Modifierfalse
                                                                                                                        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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • value @ url
                                                                                                                        • 652. Composition.section:sectionTravelHx.extension:section-note
                                                                                                                          Slice Namesection-note
                                                                                                                          Definition

                                                                                                                          Additional notes that apply to the section (but not to specific resource).

                                                                                                                          ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                                          Comments

                                                                                                                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                          Control0..*
                                                                                                                          TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                          Is Modifierfalse
                                                                                                                          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())
                                                                                                                          654. Composition.section:sectionTravelHx.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())
                                                                                                                          656. Composition.section:sectionTravelHx.title
                                                                                                                          Definition

                                                                                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                          ShortLabel for section (e.g. for ToC)
                                                                                                                          Comments

                                                                                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                          Control1..1
                                                                                                                          Typestring
                                                                                                                          Is Modifierfalse
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                          Alternate Namesheader, label, caption
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          658. Composition.section:sectionTravelHx.code
                                                                                                                          Definition

                                                                                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                          ShortClassification of section (recommended)
                                                                                                                          Comments

                                                                                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                          Control1..1
                                                                                                                          BindingFor example codes, see DocumentSectionCodes
                                                                                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                                          Classification of a section of a composition/document.

                                                                                                                          TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Provides computable standardized labels to topics within the document.

                                                                                                                          Pattern Value{
                                                                                                                            "coding" : [{
                                                                                                                              "system" : "http://loinc.org",
                                                                                                                              "code" : "10182-4"
                                                                                                                            }]
                                                                                                                          }
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          660. Composition.section:sectionTravelHx.author
                                                                                                                          Definition

                                                                                                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                          ShortWho and/or what authored the section
                                                                                                                          Control0..*
                                                                                                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Identifies who is responsible for the content.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          662. Composition.section:sectionTravelHx.focus
                                                                                                                          Definition

                                                                                                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                          ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                          Comments

                                                                                                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                                          A human-readable narrative that contains the attested content of the section, 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.

                                                                                                                          ShortText summary of the section, for human interpretation
                                                                                                                          Comments

                                                                                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                          Control1..1
                                                                                                                          This element is affected by the following invariants: cmp-1
                                                                                                                          TypeNarrative
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          666. Composition.section:sectionTravelHx.mode
                                                                                                                          Definition

                                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                          Shortworking | snapshot | changes
                                                                                                                          Comments

                                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                          Control0..1
                                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                          The processing mode that applies to this section.

                                                                                                                          Typecode
                                                                                                                          Is Modifierfalse
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          668. Composition.section:sectionTravelHx.orderedBy
                                                                                                                          Definition

                                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                                          ShortOrder of section entries
                                                                                                                          Comments

                                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                          Control0..1
                                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                                          What order applies to the items in the entry.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          670. Composition.section:sectionTravelHx.entry
                                                                                                                          Definition

                                                                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                          ShortA reference to data that supports this section
                                                                                                                          Comments

                                                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                          Control0..*
                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                          TypeReference(Observation: country visited (HDR))
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          672. Composition.section:sectionTravelHx.emptyReason
                                                                                                                          Definition

                                                                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                          ShortWhy the section is empty
                                                                                                                          Comments

                                                                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                          Control0..1
                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                                          If a section is empty, why it is empty.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          674. Composition.section:sectionTravelHx.section
                                                                                                                          Definition

                                                                                                                          A nested sub-section within this section.

                                                                                                                          ShortNested Section
                                                                                                                          Comments

                                                                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                          Control0..0
                                                                                                                          This element is affected by the following invariants: cmp-1
                                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          676. Composition.section:sectionPatientHx
                                                                                                                          Slice NamesectionPatientHx
                                                                                                                          Definition

                                                                                                                          This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.

                                                                                                                          ShortPatient History Section
                                                                                                                          Control0..1
                                                                                                                          TypeBackboneElement
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ips-comp-1: Either section.entry or emptyReason are present ((entry.reference.exists() or emptyReason.exists()))
                                                                                                                          678. Composition.section:sectionPatientHx.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
                                                                                                                          680. Composition.section:sectionPatientHx.extension
                                                                                                                          Definition

                                                                                                                          An Extension

                                                                                                                          ShortExtension
                                                                                                                          Control0..*
                                                                                                                          TypeExtension
                                                                                                                          Is Modifierfalse
                                                                                                                          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 Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                          • value @ url
                                                                                                                          • 682. Composition.section:sectionPatientHx.extension:section-note
                                                                                                                            Slice Namesection-note
                                                                                                                            Definition

                                                                                                                            Additional notes that apply to the section (but not to specific resource).

                                                                                                                            ShortAdditional notes that apply to the section (but not to specific resource).
                                                                                                                            Comments

                                                                                                                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                            Control0..*
                                                                                                                            TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                            Is Modifierfalse
                                                                                                                            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())
                                                                                                                            684. Composition.section:sectionPatientHx.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())
                                                                                                                            686. Composition.section:sectionPatientHx.title
                                                                                                                            Definition

                                                                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                            ShortLabel for section (e.g. for ToC)
                                                                                                                            Comments

                                                                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                            Control1..1
                                                                                                                            Typestring
                                                                                                                            Is Modifierfalse
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                            Alternate Namesheader, label, caption
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            688. Composition.section:sectionPatientHx.code
                                                                                                                            Definition

                                                                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                            ShortClassification of section (recommended)
                                                                                                                            Comments

                                                                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                            Control1..1
                                                                                                                            BindingFor example codes, see DocumentSectionCodes
                                                                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1)

                                                                                                                            Classification of a section of a composition/document.

                                                                                                                            TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Provides computable standardized labels to topics within the document.

                                                                                                                            Pattern Value{
                                                                                                                              "coding" : [{
                                                                                                                                "system" : "http://loinc.org",
                                                                                                                                "code" : "11329-0"
                                                                                                                              }]
                                                                                                                            }
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            690. Composition.section:sectionPatientHx.author
                                                                                                                            Definition

                                                                                                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                            ShortWho and/or what authored the section
                                                                                                                            Control0..*
                                                                                                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Identifies who is responsible for the content.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            692. Composition.section:sectionPatientHx.focus
                                                                                                                            Definition

                                                                                                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                            ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                            Comments

                                                                                                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

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

                                                                                                                            A human-readable narrative that contains the attested content of the section, 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.

                                                                                                                            ShortText summary of the section, for human interpretation
                                                                                                                            Comments

                                                                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                            Control1..1
                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                            TypeNarrative
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            696. Composition.section:sectionPatientHx.mode
                                                                                                                            Definition

                                                                                                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                            Shortworking | snapshot | changes
                                                                                                                            Comments

                                                                                                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                            Control0..1
                                                                                                                            BindingThe codes SHALL be taken from ListMode
                                                                                                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                            The processing mode that applies to this section.

                                                                                                                            Typecode
                                                                                                                            Is Modifierfalse
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            698. Composition.section:sectionPatientHx.orderedBy
                                                                                                                            Definition

                                                                                                                            Specifies the order applied to the items in the section entries.

                                                                                                                            ShortOrder of section entries
                                                                                                                            Comments

                                                                                                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                            Control0..1
                                                                                                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

                                                                                                                            What order applies to the items in the entry.

                                                                                                                            TypeCodeableConcept
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            700. Composition.section:sectionPatientHx.entry
                                                                                                                            Definition

                                                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                            ShortA reference to data that supports this section
                                                                                                                            Comments

                                                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                            Control0..*
                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                            TypeReference(Resource)
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            702. Composition.section:sectionPatientHx.emptyReason
                                                                                                                            Definition

                                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                            ShortWhy the section is empty
                                                                                                                            Comments

                                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                            Control0..1
                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

                                                                                                                            If a section is empty, why it is empty.

                                                                                                                            TypeCodeableConcept
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            704. Composition.section:sectionPatientHx.section
                                                                                                                            Definition

                                                                                                                            A nested sub-section within this section.

                                                                                                                            ShortNested Section
                                                                                                                            Comments

                                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                            Control0..0
                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))