XpanDH Hospital Discharge Report
0.1.0 - ci-build 150

XpanDH Hospital Discharge Report, published by XpanDH Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/xpandh-hdr/ and changes regularly. See the Directory of published versions

## Logical Model: HdrEHNAdvanceDirectives - JSON Profile

Draft as of 2025-10-10

JSON representation of the HDRAdvanceDirectives logical model.

Raw json | Download

    {
      "resourceType" : "StructureDefinition",
      "id" : "HDRAdvanceDirectives",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition HDRAdvanceDirectives</b></p><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives\" title=\"Hospital Discharge Report - Advance Directives - A.2.1 eHN\nMaturity Level: 0 Draft\">HDRAdvanceDirectives</a><a name=\"HDRAdvanceDirectives\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/types.html#Base\">Base</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1 - Advance Directives (eHN)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives.livingWill\" title=\"Only directives being expressed during current inpatient stay. Multiple records of living wills could be provided.\">livingWill</a><a name=\"HDRAdvanceDirectives.livingWill\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1.1 - Living will<br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives.livingWill.date\" title=\"The date and time on which the living will was recorded.\">date</a><a name=\"HDRAdvanceDirectives.livingWill.date\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1.1.1 - Date and time</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives.livingWill.type\" title=\"Type of a living will, e.g. Do not resuscitate, donorship statement, power of attorney etc.\">type</a><a name=\"HDRAdvanceDirectives.livingWill.type\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1.1.2 - Type</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives.livingWill.comment\" title=\"Comment on the living will.\">comment</a><a name=\"HDRAdvanceDirectives.livingWill.comment\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1.1.3 - Comment</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives.livingWill.conditions\" title=\"The problem or disorder to which the living will applies. Multiple fields could be provided.\">conditions</a><a name=\"HDRAdvanceDirectives.livingWill.conditions\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1.1.4 - Related conditions<br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-HDRAdvanceDirectives-definitions.html#HDRAdvanceDirectives.livingWill.document\" title=\"Scanned source document with the living will and the patient's signature, such as a PDF.\">document</a><a name=\"HDRAdvanceDirectives.livingWill.document\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A.2.1.1.5 - Living will document</td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
      },
      "url" : "http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/HDRAdvanceDirectives",
      "version" : "0.1.0",
      "name" : "HdrEHNAdvanceDirectives",
      "title" : "A.2.1 - Advance Directives (eHN)",
      "status" : "draft",
      "date" : "2025-10-10T16:32:47+00:00",
      "publisher" : "XpanDH Project",
      "contact" : [
        {
          "name" : "XpanDH Project",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://xpandh-project.iscte-iul.pt"
            }
          ]
        }
      ],
      "description" : "Hospital Discharge Report - Advance Directives - A.2.1 eHN\nMaturity Level: 0 Draft",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
              "code" : "150",
              "display" : "Europe"
            }
          ]
        }
      ],
      "copyright" : "Used by permission of the XpanDH project, all rights reserved Creative Commons License",
      "fhirVersion" : "4.0.1",
      "kind" : "logical",
      "abstract" : false,
      "type" : "http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/HDRAdvanceDirectives",
      "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Base",
      "derivation" : "specialization",
      "snapshot" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
            "valueString" : "4.0.1"
          }
        ],
        "element" : [
          {
            "id" : "HDRAdvanceDirectives",
            "path" : "HDRAdvanceDirectives",
            "short" : "A.2.1 - Advance Directives (eHN)",
            "definition" : "Hospital Discharge Report - Advance Directives - A.2.1 eHN\nMaturity Level: 0 Draft",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Base",
              "min" : 0,
              "max" : "*"
            },
            "isModifier" : false
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill",
            "path" : "HDRAdvanceDirectives.livingWill",
            "short" : "A.2.1.1 - Living will",
            "definition" : "Only directives being expressed during current inpatient stay. Multiple records of living wills could be provided.",
            "min" : 1,
            "max" : "*",
            "base" : {
              "path" : "HDRAdvanceDirectives.livingWill",
              "min" : 1,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "BackboneElement"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.id",
            "path" : "HDRAdvanceDirectives.livingWill.id",
            "representation" : [
              "xmlAttr"
            ],
            "short" : "Unique id for inter-element referencing",
            "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "Element.id",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                    "valueUrl" : "string"
                  }
                ],
                "code" : "http://hl7.org/fhirpath/System.String"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "n/a"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.extension",
            "path" : "HDRAdvanceDirectives.livingWill.extension",
            "slicing" : {
              "discriminator" : [
                {
                  "type" : "value",
                  "path" : "url"
                }
              ],
              "description" : "Extensions are always sliced by (at least) url",
              "rules" : "open"
            },
            "short" : "Additional content defined by implementations",
            "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.",
            "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
            "alias" : [
              "extensions",
              "user content"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "Element.extension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : false,
            "isSummary" : false,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "n/a"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.modifierExtension",
            "path" : "HDRAdvanceDirectives.livingWill.modifierExtension",
            "short" : "Extensions that cannot be ignored even if unrecognized",
            "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
            "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
            "requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
            "alias" : [
              "extensions",
              "user content",
              "modifiers"
            ],
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "BackboneElement.modifierExtension",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "Extension"
              }
            ],
            "constraint" : [
              {
                "key" : "ele-1",
                "severity" : "error",
                "human" : "All FHIR elements must have a @value or children",
                "expression" : "hasValue() or (children().count() > id.count())",
                "xpath" : "@value|f:*|h:div",
                "source" : "http://hl7.org/fhir/StructureDefinition/Element"
              },
              {
                "key" : "ext-1",
                "severity" : "error",
                "human" : "Must have either extensions or value[x], not both",
                "expression" : "extension.exists() != value.exists()",
                "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
              }
            ],
            "isModifier" : true,
            "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
            "isSummary" : true,
            "mapping" : [
              {
                "identity" : "rim",
                "map" : "N/A"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.date",
            "path" : "HDRAdvanceDirectives.livingWill.date",
            "short" : "A.2.1.1.1 - Date and time",
            "definition" : "The date and time on which the living will was recorded.",
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "HDRAdvanceDirectives.livingWill.date",
              "min" : 1,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "dateTime"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.type",
            "path" : "HDRAdvanceDirectives.livingWill.type",
            "short" : "A.2.1.1.2 - Type",
            "definition" : "Type of a living will, e.g. Do not resuscitate, donorship statement, power of attorney etc.",
            "comment" : "SNOMED CT",
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "HDRAdvanceDirectives.livingWill.type",
              "min" : 1,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.comment",
            "path" : "HDRAdvanceDirectives.livingWill.comment",
            "short" : "A.2.1.1.3 - Comment",
            "definition" : "Comment on the living will.",
            "min" : 0,
            "max" : "1",
            "base" : {
              "path" : "HDRAdvanceDirectives.livingWill.comment",
              "min" : 0,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "string"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.conditions",
            "path" : "HDRAdvanceDirectives.livingWill.conditions",
            "short" : "A.2.1.1.4 - Related conditions",
            "definition" : "The problem or disorder to which the living will applies. Multiple fields could be provided.",
            "comment" : "ICD-10*\nSNOMED CT\nOrphacode if rare disease is diagnosed",
            "min" : 0,
            "max" : "*",
            "base" : {
              "path" : "HDRAdvanceDirectives.livingWill.conditions",
              "min" : 0,
              "max" : "*"
            },
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.document",
            "path" : "HDRAdvanceDirectives.livingWill.document",
            "short" : "A.2.1.1.5 - Living will document",
            "definition" : "Scanned source document with the living will and the patient's signature, such as a PDF.",
            "min" : 1,
            "max" : "1",
            "base" : {
              "path" : "HDRAdvanceDirectives.livingWill.document",
              "min" : 1,
              "max" : "1"
            },
            "type" : [
              {
                "code" : "BackboneElement"
              }
            ]
          }
        ]
      },
      "differential" : {
        "element" : [
          {
            "id" : "HDRAdvanceDirectives",
            "path" : "HDRAdvanceDirectives",
            "short" : "A.2.1 - Advance Directives (eHN)",
            "definition" : "Hospital Discharge Report - Advance Directives - A.2.1 eHN\nMaturity Level: 0 Draft"
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill",
            "path" : "HDRAdvanceDirectives.livingWill",
            "short" : "A.2.1.1 - Living will",
            "definition" : "Only directives being expressed during current inpatient stay. Multiple records of living wills could be provided.",
            "min" : 1,
            "max" : "*",
            "type" : [
              {
                "code" : "BackboneElement"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.date",
            "path" : "HDRAdvanceDirectives.livingWill.date",
            "short" : "A.2.1.1.1 - Date and time",
            "definition" : "The date and time on which the living will was recorded.",
            "min" : 1,
            "max" : "1",
            "type" : [
              {
                "code" : "dateTime"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.type",
            "path" : "HDRAdvanceDirectives.livingWill.type",
            "short" : "A.2.1.1.2 - Type",
            "definition" : "Type of a living will, e.g. Do not resuscitate, donorship statement, power of attorney etc.",
            "comment" : "SNOMED CT",
            "min" : 1,
            "max" : "1",
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.comment",
            "path" : "HDRAdvanceDirectives.livingWill.comment",
            "short" : "A.2.1.1.3 - Comment",
            "definition" : "Comment on the living will.",
            "min" : 0,
            "max" : "1",
            "type" : [
              {
                "code" : "string"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.conditions",
            "path" : "HDRAdvanceDirectives.livingWill.conditions",
            "short" : "A.2.1.1.4 - Related conditions",
            "definition" : "The problem or disorder to which the living will applies. Multiple fields could be provided.",
            "comment" : "ICD-10*\nSNOMED CT\nOrphacode if rare disease is diagnosed",
            "min" : 0,
            "max" : "*",
            "type" : [
              {
                "code" : "CodeableConcept"
              }
            ]
          },
          {
            "id" : "HDRAdvanceDirectives.livingWill.document",
            "path" : "HDRAdvanceDirectives.livingWill.document",
            "short" : "A.2.1.1.5 - Living will document",
            "definition" : "Scanned source document with the living will and the patient's signature, such as a PDF.",
            "min" : 1,
            "max" : "1",
            "type" : [
              {
                "code" : "BackboneElement"
              }
            ]
          }
        ]
      }
    }