CH IPS (R4)
1.0.0-ci-build - ci-build Switzerland flag

CH IPS (R4), published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7ch/ch-ips/ and changes regularly. See the Directory of published versions

Resource Profile: ChIpsComposition - Detailed Descriptions

Active as of 2024-10-15

Definitions for the ch-ips-composition resource profile.

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

0. Composition
ShortCH IPS Composition
Impose ProfileThis profile also requires that the instance also conform this additional profile:
2. Composition.subject
TypeReference(CH IPS Patient)
4. Composition.relatesTo
6. Composition.relatesTo.target[x]
TypeChoice of: Identifier, Reference(CH IPS Composition)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
8. Composition.section
Control3..?
10. Composition.section:sectionMedications
Slice NamesectionMedications
Control1..1
12. Composition.section:sectionMedications.code
Control1..?
Pattern Value{
  "coding" : [{
    "system" : "http://loinc.org",
    "code" : "10160-0"
  }]
}
14. Composition.section:sectionMedications.entry
SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • profile @ resolve()
  • 16. Composition.section:sectionMedications.entry:medicationStatement
    Slice NamemedicationStatement
    Control0..*
    TypeReference(CH IPS MedicationStatement)
    18. Composition.section:sectionMedications.entry:medicationRequest
    Slice NamemedicationRequest
    Control0..*
    TypeReference(CH IPS MedicationRequest)
    20. Composition.section:sectionAllergies
    Slice NamesectionAllergies
    Control1..1
    22. Composition.section:sectionAllergies.code
    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "48765-2"
      }]
    }
    24. Composition.section:sectionAllergies.entry
    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ resolve()
    • 26. Composition.section:sectionAllergies.entry:allergyOrIntolerance
      Slice NameallergyOrIntolerance
      Control0..*
      TypeReference(CH IPS AllergyIntolerance)
      28. Composition.section:sectionProblems
      Slice NamesectionProblems
      Control1..1
      30. Composition.section:sectionProblems.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "11450-4"
        }]
      }
      32. Composition.section:sectionProblems.entry
      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 34. Composition.section:sectionProblems.entry:problem
        Slice Nameproblem
        Control0..*
        TypeReference(CH IPS Condition)
        36. Composition.section:sectionProceduresHx
        Slice NamesectionProceduresHx
        Control0..1
        38. Composition.section:sectionProceduresHx.code
        Control1..?
        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "47519-4"
          }]
        }
        40. Composition.section:sectionProceduresHx.entry
        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 42. Composition.section:sectionProceduresHx.entry:procedure
          Slice Nameprocedure
          Control0..*
          TypeReference(Procedure (IPS))
          44. Composition.section:sectionImmunizations
          Slice NamesectionImmunizations
          Control0..1
          46. Composition.section:sectionImmunizations.code
          Control1..?
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "11369-6"
            }]
          }
          48. Composition.section:sectionImmunizations.entry
          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • profile @ resolve()
          • 50. Composition.section:sectionImmunizations.entry:immunization
            Slice Nameimmunization
            Control0..*
            TypeReference(CH IPS Immunization)
            52. Composition.section:sectionMedicalDevices
            Slice NamesectionMedicalDevices
            Control0..1
            54. Composition.section:sectionMedicalDevices.code
            Control1..?
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "46264-8"
              }]
            }
            56. Composition.section:sectionMedicalDevices.entry
            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ resolve()
            • 58. Composition.section:sectionMedicalDevices.entry:deviceStatement
              Slice NamedeviceStatement
              Control0..*
              TypeReference(Device Use Statement (IPS))
              60. Composition.section:sectionResults
              Slice NamesectionResults
              Control0..1
              62. Composition.section:sectionResults.code
              Control1..?
              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "30954-2"
                }]
              }
              64. Composition.section:sectionResults.entry
              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()
              • profile @ resolve()
              • 66. Composition.section:sectionResults.entry:resultsObservationLaboratoryPathology
                Slice NameresultsObservationLaboratoryPathology
                Control0..*
                TypeReference(Observation Results: laboratory/pathology (IPS))
                68. Composition.section:sectionResults.entry:resultsObservationRadiology
                Slice NameresultsObservationRadiology
                Control0..*
                TypeReference(Observation Results: radiology (IPS))
                70. Composition.section:sectionResults.entry:resultsDiagnosticReport
                Slice NameresultsDiagnosticReport
                Control0..*
                TypeReference(DiagnosticReport (IPS))
                72. Composition.section:sectionVitalSigns
                Slice NamesectionVitalSigns
                Control0..1
                74. Composition.section:sectionVitalSigns.code
                Control1..?
                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "8716-3"
                  }]
                }
                76. Composition.section:sectionVitalSigns.entry
                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ resolve()
                • 78. Composition.section:sectionVitalSigns.entry:vitalSign
                  Slice NamevitalSign
                  Control0..*
                  TypeReference(Vital Signs Profile)
                  80. Composition.section:sectionPastIllnessHx
                  Slice NamesectionPastIllnessHx
                  Control0..1
                  82. Composition.section:sectionPastIllnessHx.code
                  Control1..?
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "11348-0"
                    }]
                  }
                  84. Composition.section:sectionPastIllnessHx.entry
                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • profile @ resolve()
                  • 86. Composition.section:sectionPastIllnessHx.entry:pastProblem
                    Slice NamepastProblem
                    Control0..*
                    TypeReference(CH IPS Condition)
                    88. Composition.section:sectionFunctionalStatus
                    Slice NamesectionFunctionalStatus
                    Control0..1
                    90. Composition.section:sectionFunctionalStatus.code
                    Control1..?
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "47420-5"
                      }]
                    }
                    92. Composition.section:sectionFunctionalStatus.entry
                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • profile @ resolve()
                    • 94. Composition.section:sectionFunctionalStatus.entry:disability
                      Slice Namedisability
                      Control0..*
                      TypeReference(CH IPS Condition)
                      96. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
                      Slice NamefunctionalAssessment
                      Control0..*
                      TypeReference(ClinicalImpression)
                      98. Composition.section:sectionPlanOfCare
                      Slice NamesectionPlanOfCare
                      Control0..1
                      100. Composition.section:sectionPlanOfCare.code
                      Control1..?
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "18776-5"
                        }]
                      }
                      102. Composition.section:sectionPlanOfCare.entry
                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ resolve()
                      • 104. Composition.section:sectionPlanOfCare.entry:carePlan
                        Slice NamecarePlan
                        Control0..*
                        TypeReference(CarePlan)
                        106. Composition.section:sectionSocialHistory
                        Slice NamesectionSocialHistory
                        Control0..1
                        108. Composition.section:sectionSocialHistory.code
                        Control1..?
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "29762-2"
                          }]
                        }
                        110. Composition.section:sectionSocialHistory.entry
                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 112. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
                          Slice NamesmokingTobaccoUse
                          Control0..1
                          TypeReference(Observation - SH: tobacco use)
                          114. Composition.section:sectionSocialHistory.entry:alcoholUse
                          Slice NamealcoholUse
                          Control0..1
                          TypeReference(Observation - SH: alcohol use)
                          116. Composition.section:sectionPregnancyHx
                          Slice NamesectionPregnancyHx
                          Control0..1
                          118. Composition.section:sectionPregnancyHx.code
                          Control1..?
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "10162-6"
                            }]
                          }
                          120. Composition.section:sectionPregnancyHx.entry
                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • profile @ resolve()
                          • 122. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
                            Slice NamepregnancyStatus
                            Control0..*
                            TypeReference(Observation - Pregnancy: status)
                            124. Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
                            Slice NamepregnancyOutcomeSummary
                            Control0..*
                            TypeReference(Observation - Pregnancy: outcome)
                            126. Composition.section:sectionAdvanceDirectives
                            Slice NamesectionAdvanceDirectives
                            Control0..1
                            128. Composition.section:sectionAdvanceDirectives.code
                            Control1..?
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "42348-3"
                              }]
                            }
                            130. Composition.section:sectionAdvanceDirectives.entry
                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • profile @ resolve()
                            • 132. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
                              Slice NameadvanceDirectivesConsent
                              Control0..*
                              TypeReference(Consent)
                              134. Composition.section:sectionAlerts
                              Slice NamesectionAlerts
                              Control0..1
                              136. Composition.section:sectionAlerts.code
                              Control1..?
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "104605-1"
                                }]
                              }
                              138. Composition.section:sectionAlerts.entry
                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • profile @ resolve()
                              • 140. Composition.section:sectionAlerts.entry:alertsFlag
                                Slice NamealertsFlag
                                Control0..*
                                TypeReference(Flag - Alert (IPS))
                                142. Composition.section:sectionPatientStory
                                Slice NamesectionPatientStory
                                Control0..1
                                144. Composition.section:sectionPatientStory.code
                                Control1..?
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "81338-6"
                                  }]
                                }

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

                                0. Composition
                                Definition

                                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.).

                                ShortCH IPS 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.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).

                                Control10..1
                                BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
                                (preferred to http://hl7.org/fhir/ValueSet/languages)

                                A human language.

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

                                Extension to define the information about the recipient

                                ShortExtension
                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension(EPR Information Recipient) (Extension Type: Reference)
                                Is Modifierfalse
                                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())
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                8. Composition.extension:dataEnterer
                                Slice NamedataEnterer
                                Definition

                                Extension to define the information about the person and organization that entered data and the time of the data input

                                ShortExtension
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(EPR Data Enterer) (Complex Extension)
                                Is Modifierfalse
                                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.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())
                                12. Composition.identifier
                                Definition

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

                                ShortVersion-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)
                                Control10..1
                                TypeIdentifier
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                14. Composition.identifier.use
                                Definition

                                The purpose of this identifier.

                                Shortusual | official | temp | secondary | old (If known)
                                Comments

                                Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                Control0..1
                                BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                Identifies the purpose for this identifier, if known .

                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                                Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                ShortThe namespace for the identifier value
                                Comments

                                Identifier.system is always case sensitive.

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

                                There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                Fixed Valueurn:ietf:rfc:3986
                                Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                18. Composition.identifier.value
                                Definition

                                The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                ShortThe value that is unique
                                Comments

                                If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                Control10..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Example<br/><b>General</b>:123456
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                20. Composition.status
                                Definition

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

                                Shortpreliminary | 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()))
                                22. Composition.type
                                Definition

                                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 compositionKind 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
                                BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from DocumentEntry.typeCodehttp://hl7.org/fhir/ValueSet/doc-typecodes
                                (extensible to http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.typeCode)
                                TypeCodeableConcept
                                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()))
                                24. Composition.subject
                                Definition

                                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(CH IPS Patient, 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()))
                                26. Composition.subject.reference
                                Definition

                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                ShortLiteral reference, Relative, internal or absolute URL
                                Comments

                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                Control10..1
                                This element is affected by the following invariants: ref-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()))
                                28. Composition.date
                                Definition

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

                                ShortComposition 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()))
                                30. Composition.author
                                Definition

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

                                ShortWho and/or what authored the composition
                                Control1..*
                                TypeReference(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR, Practitioner, PractitionerRole, Patient, 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()))
                                32. Composition.author.extension:time
                                Slice Nametime
                                Definition

                                Extension to define the timestamp of the authorship/data input

                                ShortTimestamp of the authorship/data input
                                Control0..1
                                TypeExtension(EPR Time) (Extension Type: dateTime)
                                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())
                                34. Composition.author.reference
                                Definition

                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                ShortLiteral reference, Relative, internal or absolute URL
                                Comments

                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                Control10..1
                                This element is affected by the following invariants: ref-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()))
                                36. Composition.title
                                Definition

                                Official human-readable label for the composition.

                                ShortHuman 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()))
                                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.

                                Control10..1
                                BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)http://terminology.hl7.org/ValueSet/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.confidentiality.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.

                                Control10..*
                                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())
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Composition.confidentiality.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 42. Composition.confidentiality.extension:confidentialityCode
                                  Slice NameconfidentialityCode
                                  Definition

                                  Extension to define the confidentiality code of the document

                                  ShortExtension
                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(EPR Confidentiality Code) (Extension Type: CodeableConcept)
                                  Is Modifierfalse
                                  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())
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  44. 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()))
                                  SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ mode
                                  • 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.

                                    Shortpersonal | professional | legal | official
                                    Control1..1
                                    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                                    (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:legalAuthenticator
                                    Slice NamelegalAuthenticator
                                    Definition

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

                                    Shortlegal authenticatorAttests to accuracy of composition
                                    Comments

                                    Only list each attester once.

                                    Control0..1*
                                    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()))
                                    52. Composition.attester:legalAuthenticator.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())
                                    54. Composition.attester:legalAuthenticator.mode
                                    Definition

                                    The type of attestation the authenticator offers.

                                    Shortpersonal | professional | legal | official
                                    Control1..1
                                    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                                    (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.

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

                                    Who attested the composition in the specified way.

                                    ShortWho attested the composition
                                    Control10..1
                                    TypeReference(CH Core Patient EPR, RelatedPerson, CH Core Practitioner EPR, CH Core PractitionerRole EPR, Patient, Practitioner, PractitionerRole, Organization)
                                    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()))
                                    58. Composition.attester:legalAuthenticator.party.reference
                                    Definition

                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                    ShortLiteral reference, Relative, internal or absolute URL
                                    Comments

                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                    Control10..1
                                    This element is affected by the following invariants: ref-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()))
                                    60. Composition.section
                                    Definition

                                    The root of the sections that make up the composition.

                                    ShortComposition 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:
                                    • pattern @ code
                                    • 62. 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())
                                      64. Composition.section:originalRepresentation
                                      Slice NameoriginalRepresentation
                                      Definition

                                      The root of the sections that make up the composition.

                                      ShortContains the original representation as a PDF of the current document.Composition 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())
                                      66. Composition.section:originalRepresentation.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())
                                      68. Composition.section:originalRepresentation.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.

                                      ShortOriginal representationLabel 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()))
                                      70. Composition.section:originalRepresentation.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
                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                      Classification of a section of a composition/document.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Provides computable standardized labels to topics within the document.

                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "55108-5"
                                        }]
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      72. Composition.section:originalRepresentation.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.

                                      ShortRepresentation of the original viewText 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()))
                                      74. Composition.section:originalRepresentation.entry
                                      Definition

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

                                      ShortAccording to the EPR ordonnance the PDF has to be in PDF/A-1 or PDF/A-2 format.A reference to data that supports this section
                                      Comments

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

                                      Control10..1*
                                      This element is affected by the following invariants: cmp-2
                                      TypeReference(Binary, Resource)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      76. Composition.section:originalRepresentation.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 root of the sections that make up the composition.

                                      ShortComposition 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()))
                                      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.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())
                                      82. 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
                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                      Classification of a section of a composition/document.

                                      TypeCodeableConcept
                                      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()))
                                      84. Composition.section:sectionMedications.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()))
                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • profile @ resolve()
                                      • 86. Composition.section:sectionMedications.entry:medicationStatement
                                        Slice NamemedicationStatement
                                        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(CH IPS MedicationStatement, Resource)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        88. Composition.section:sectionMedications.entry:medicationRequest
                                        Slice NamemedicationRequest
                                        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(CH IPS MedicationRequest, Resource)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        90. Composition.section:sectionAllergies
                                        Slice NamesectionAllergies
                                        Definition

                                        The root of the sections that make up the composition.

                                        ShortComposition 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()))
                                        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())
                                        92. 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())
                                        94. 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
                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                        Classification of a section of a composition/document.

                                        TypeCodeableConcept
                                        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()))
                                        96. Composition.section:sectionAllergies.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()))
                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • profile @ resolve()
                                        • 98. Composition.section:sectionAllergies.entry:allergyOrIntolerance
                                          Slice NameallergyOrIntolerance
                                          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(CH IPS AllergyIntolerance, Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          100. Composition.section:sectionProblems
                                          Slice NamesectionProblems
                                          Definition

                                          The root of the sections that make up the composition.

                                          ShortComposition 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()))
                                          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())
                                          102. 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())
                                          104. 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
                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                          Classification of a section of a composition/document.

                                          TypeCodeableConcept
                                          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()))
                                          106. Composition.section:sectionProblems.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()))
                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • profile @ resolve()
                                          • 108. Composition.section:sectionProblems.entry:problem
                                            Slice Nameproblem
                                            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(CH IPS Condition, Resource)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            110. Composition.section:sectionProceduresHx
                                            Slice NamesectionProceduresHx
                                            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())
                                            112. 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())
                                            114. 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
                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            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()))
                                            116. Composition.section:sectionProceduresHx.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()))
                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • profile @ resolve()
                                            • 118. Composition.section:sectionProceduresHx.entry:procedure
                                              Slice Nameprocedure
                                              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(Procedure (IPS), Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              120. Composition.section:sectionImmunizations
                                              Slice NamesectionImmunizations
                                              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())
                                              122. 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())
                                              124. 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
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              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()))
                                              126. Composition.section:sectionImmunizations.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()))
                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ resolve()
                                              • 128. Composition.section:sectionImmunizations.entry:immunization
                                                Slice Nameimmunization
                                                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(CH IPS Immunization, Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                130. Composition.section:sectionMedicalDevices
                                                Slice NamesectionMedicalDevices
                                                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())
                                                132. 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())
                                                134. 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
                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                Classification of a section of a composition/document.

                                                TypeCodeableConcept
                                                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()))
                                                136. Composition.section:sectionMedicalDevices.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()))
                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • profile @ resolve()
                                                • 138. Composition.section:sectionMedicalDevices.entry:deviceStatement
                                                  Slice NamedeviceStatement
                                                  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(Device Use Statement (IPS), Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  140. Composition.section:sectionResults
                                                  Slice NamesectionResults
                                                  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())
                                                  142. 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())
                                                  144. 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
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "30954-2"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  146. 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()))
                                                  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()
                                                  • profile @ resolve()
                                                  • 148. Composition.section:sectionResults.entry:resultsObservationLaboratoryPathology
                                                    Slice NameresultsObservationLaboratoryPathology
                                                    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 Results: laboratory/pathology (IPS), Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    150. Composition.section:sectionResults.entry:resultsObservationRadiology
                                                    Slice NameresultsObservationRadiology
                                                    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 Results: radiology (IPS), Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    152. Composition.section:sectionResults.entry:resultsDiagnosticReport
                                                    Slice NameresultsDiagnosticReport
                                                    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(DiagnosticReport (IPS), Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    154. Composition.section:sectionVitalSigns
                                                    Slice NamesectionVitalSigns
                                                    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())
                                                    156. 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())
                                                    158. 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
                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                    Classification of a section of a composition/document.

                                                    TypeCodeableConcept
                                                    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()))
                                                    160. Composition.section:sectionVitalSigns.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()))
                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • profile @ resolve()
                                                    • 162. Composition.section:sectionVitalSigns.entry:vitalSign
                                                      Slice NamevitalSign
                                                      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(Vital Signs Profile, Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      164. Composition.section:sectionPastIllnessHx
                                                      Slice NamesectionPastIllnessHx
                                                      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())
                                                      166. Composition.section:sectionPastIllnessHx.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())
                                                      168. Composition.section:sectionPastIllnessHx.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
                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                      Classification of a section of a composition/document.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Provides computable standardized labels to topics within the document.

                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "11348-0"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      170. Composition.section:sectionPastIllnessHx.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()))
                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • profile @ resolve()
                                                      • 172. Composition.section:sectionPastIllnessHx.entry:pastProblem
                                                        Slice NamepastProblem
                                                        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(CH IPS Condition, Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        174. Composition.section:sectionFunctionalStatus
                                                        Slice NamesectionFunctionalStatus
                                                        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())
                                                        176. 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())
                                                        178. 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
                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                        Classification of a section of a composition/document.

                                                        TypeCodeableConcept
                                                        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()))
                                                        180. Composition.section:sectionFunctionalStatus.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()))
                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • profile @ resolve()
                                                        • 182. Composition.section:sectionFunctionalStatus.entry:disability
                                                          Slice Namedisability
                                                          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(CH IPS Condition, Resource)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          184. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
                                                          Slice NamefunctionalAssessment
                                                          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(ClinicalImpression, Resource)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          186. Composition.section:sectionPlanOfCare
                                                          Slice NamesectionPlanOfCare
                                                          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())
                                                          188. 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())
                                                          190. 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
                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                          Classification of a section of a composition/document.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides computable standardized labels to topics within the document.

                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "18776-5"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          192. 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()))
                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • profile @ resolve()
                                                          • 194. Composition.section:sectionPlanOfCare.entry:carePlan
                                                            Slice NamecarePlan
                                                            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(CarePlan, Resource)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            196. Composition.section:sectionSocialHistory
                                                            Slice NamesectionSocialHistory
                                                            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())
                                                            198. 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())
                                                            200. 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
                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                            Classification of a section of a composition/document.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides computable standardized labels to topics within the document.

                                                            Pattern Value{
                                                              "coding" : [{
                                                                "system" : "http://loinc.org",
                                                                "code" : "29762-2"
                                                              }]
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            202. 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()))
                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • profile @ resolve()
                                                            • 204. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
                                                              Slice NamesmokingTobaccoUse
                                                              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(Observation - SH: tobacco use, Resource)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              206. Composition.section:sectionSocialHistory.entry:alcoholUse
                                                              Slice NamealcoholUse
                                                              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(Observation - SH: alcohol use, Resource)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              208. Composition.section:sectionPregnancyHx
                                                              Slice NamesectionPregnancyHx
                                                              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())
                                                              210. 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())
                                                              212. 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
                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                              Classification of a section of a composition/document.

                                                              TypeCodeableConcept
                                                              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()))
                                                              214. Composition.section:sectionPregnancyHx.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()))
                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • profile @ resolve()
                                                              • 216. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
                                                                Slice NamepregnancyStatus
                                                                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 - Pregnancy: status, Resource)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                218. Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
                                                                Slice NamepregnancyOutcomeSummary
                                                                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 - Pregnancy: outcome, Resource)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                220. Composition.section:sectionAdvanceDirectives
                                                                Slice NamesectionAdvanceDirectives
                                                                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())
                                                                222. 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())
                                                                224. 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
                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                Classification of a section of a composition/document.

                                                                TypeCodeableConcept
                                                                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()))
                                                                226. 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(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:
                                                                • profile @ resolve()
                                                                • 228. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
                                                                  Slice NameadvanceDirectivesConsent
                                                                  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, Resource)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  230. 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())
                                                                  232. 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())
                                                                  234. 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
                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                  Classification of a section of a composition/document.

                                                                  TypeCodeableConcept
                                                                  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()))
                                                                  236. 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()))
                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • profile @ resolve()
                                                                  • 238. Composition.section:sectionAlerts.entry:alertsFlag
                                                                    Slice NamealertsFlag
                                                                    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(Flag - Alert (IPS), Resource)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    240. 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())
                                                                    242. 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())
                                                                    244. 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
                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                    Classification of a section of a composition/document.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides computable standardized labels to topics within the document.

                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://loinc.org",
                                                                        "code" : "81338-6"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                                                                    0. Composition
                                                                    Definition

                                                                    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.).

                                                                    ShortCH IPS 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).

                                                                    Control1..1
                                                                    BindingThe codes SHOULD be taken from CommonLanguages
                                                                    (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                                    A human language.

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

                                                                      Extension to define the information about the recipient

                                                                      ShortExtension
                                                                      Control0..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension(EPR Information Recipient) (Extension Type: Reference)
                                                                      Is Modifierfalse
                                                                      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.extension:dataEnterer
                                                                      Slice NamedataEnterer
                                                                      Definition

                                                                      Extension to define the information about the person and organization that entered data and the time of the data input

                                                                      ShortExtension
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension(EPR Data Enterer) (Complex Extension)
                                                                      Is Modifierfalse
                                                                      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.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())
                                                                      22. Composition.identifier
                                                                      Definition

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

                                                                      ShortVersion-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)
                                                                      Control1..1
                                                                      TypeIdentifier
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      24. Composition.identifier.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
                                                                      26. Composition.identifier.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())
                                                                      SlicingThis element introduces a set of slices on Composition.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 28. Composition.identifier.use
                                                                        Definition

                                                                        The purpose of this identifier.

                                                                        Shortusual | official | temp | secondary | old (If known)
                                                                        Comments

                                                                        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                                        Control0..1
                                                                        BindingThe codes SHALL be taken from IdentifierUse
                                                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                        Identifies the purpose for this identifier, if known .

                                                                        Typecode
                                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                                                                        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                                        ShortDescription of identifier
                                                                        Comments

                                                                        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                        Control0..1
                                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                                        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Requirements

                                                                        Allows users to make use of identifiers when the identifier system is not known.

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

                                                                        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                                        ShortThe namespace for the identifier value
                                                                        Comments

                                                                        Identifier.system is always case sensitive.

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

                                                                        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                                        Fixed Valueurn:ietf:rfc:3986
                                                                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        34. Composition.identifier.value
                                                                        Definition

                                                                        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                                        ShortThe value that is unique
                                                                        Comments

                                                                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                        Control1..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Example<br/><b>General</b>:123456
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        36. Composition.identifier.period
                                                                        Definition

                                                                        Time period during which identifier is/was valid for use.

                                                                        ShortTime period when id is/was valid for use
                                                                        Control0..1
                                                                        TypePeriod
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        38. Composition.identifier.assigner
                                                                        Definition

                                                                        Organization that issued/manages the identifier.

                                                                        ShortOrganization that issued id (may be just text)
                                                                        Comments

                                                                        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                                        Control0..1
                                                                        TypeReference(Organization)
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        40. Composition.status
                                                                        Definition

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

                                                                        Shortpreliminary | 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 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()))
                                                                        42. Composition.type
                                                                        Definition

                                                                        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
                                                                        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
                                                                        BindingUnless not suitable, these codes SHALL be taken from DocumentEntry.typeCode
                                                                        (extensible to http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.typeCode)
                                                                        TypeCodeableConcept
                                                                        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()))
                                                                        44. 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)

                                                                        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()))
                                                                        46. Composition.subject
                                                                        Definition

                                                                        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.

                                                                        Control1..1
                                                                        TypeReference(CH IPS Patient)
                                                                        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()))
                                                                        48. Composition.subject.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
                                                                        50. Composition.subject.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())
                                                                        SlicingThis element introduces a set of slices on Composition.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 52. Composition.subject.reference
                                                                          Definition

                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                          Comments

                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                          Control1..1
                                                                          This element is affected by the following invariants: ref-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()))
                                                                          54. Composition.subject.type
                                                                          Definition

                                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                          ShortType the reference refers to (e.g. "Patient")
                                                                          Comments

                                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                          Control0..1
                                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                          Aa resource (or, for logical models, the URI of the logical model).

                                                                          Typeuri
                                                                          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()))
                                                                          56. Composition.subject.identifier
                                                                          Definition

                                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                          ShortLogical reference, when literal reference is not known
                                                                          Comments

                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                          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()))
                                                                          58. Composition.subject.display
                                                                          Definition

                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                          ShortText alternative for the resource
                                                                          Comments

                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                          Control0..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()))
                                                                          60. Composition.encounter
                                                                          Definition

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

                                                                          ShortContext of the Composition
                                                                          Control0..1
                                                                          TypeReference(CH Core 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()))
                                                                          62. Composition.date
                                                                          Definition

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

                                                                          ShortComposition 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.

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

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

                                                                          ShortWho and/or what authored the composition
                                                                          Control1..*
                                                                          TypeReference(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                          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()))
                                                                          66. Composition.author.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
                                                                          68. Composition.author.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())
                                                                          SlicingThis element introduces a set of slices on Composition.author.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 70. Composition.author.extension:time
                                                                            Slice Nametime
                                                                            Definition

                                                                            Extension to define the timestamp of the authorship/data input

                                                                            ShortTimestamp of the authorship/data input
                                                                            Control0..1
                                                                            TypeExtension(EPR Time) (Extension Type: dateTime)
                                                                            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())
                                                                            72. Composition.author.reference
                                                                            Definition

                                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                                            Comments

                                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ref-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()))
                                                                            74. Composition.author.type
                                                                            Definition

                                                                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                            ShortType the reference refers to (e.g. "Patient")
                                                                            Comments

                                                                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                            Control0..1
                                                                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                            Aa resource (or, for logical models, the URI of the logical model).

                                                                            Typeuri
                                                                            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()))
                                                                            76. Composition.author.identifier
                                                                            Definition

                                                                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                            ShortLogical reference, when literal reference is not known
                                                                            Comments

                                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                            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()))
                                                                            78. Composition.author.display
                                                                            Definition

                                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                                            ShortText alternative for the resource
                                                                            Comments

                                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                            Control0..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()))
                                                                            80. Composition.title
                                                                            Definition

                                                                            Official human-readable label for the composition.

                                                                            ShortHuman 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()))
                                                                            82. 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.

                                                                            Control1..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()))
                                                                            84. Composition.confidentiality.id
                                                                            Definition

                                                                            unique id for the element within a resource (for internal references)

                                                                            Shortxml:id (or equivalent in JSON)
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            86. Composition.confidentiality.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control1..*
                                                                            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.confidentiality.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 88. Composition.confidentiality.extension:confidentialityCode
                                                                              Slice NameconfidentialityCode
                                                                              Definition

                                                                              Extension to define the confidentiality code of the document

                                                                              ShortExtension
                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(EPR Confidentiality Code) (Extension Type: CodeableConcept)
                                                                              Is Modifierfalse
                                                                              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.confidentiality.value
                                                                              Definition

                                                                              Primitive value for code

                                                                              ShortPrimitive value for code
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              92. 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()))
                                                                              SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ mode
                                                                              • 94. 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
                                                                                96. 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())
                                                                                98. 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())
                                                                                100. Composition.attester.mode
                                                                                Definition

                                                                                The type of attestation the authenticator offers.

                                                                                Shortpersonal | professional | legal | official
                                                                                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()))
                                                                                102. 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()))
                                                                                104. Composition.attester.party
                                                                                Definition

                                                                                Who attested the composition in the specified way.

                                                                                ShortWho attested the composition
                                                                                Control0..1
                                                                                TypeReference(CH Core Patient, RelatedPerson, CH Core Practitioner, CH Core PractitionerRole, CH Core Organization)
                                                                                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()))
                                                                                106. Composition.attester.party.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
                                                                                108. Composition.attester.party.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())
                                                                                SlicingThis element introduces a set of slices on Composition.attester.party.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 110. Composition.attester.party.reference
                                                                                  Definition

                                                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                                                  Comments

                                                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ref-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()))
                                                                                  112. Composition.attester.party.type
                                                                                  Definition

                                                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                  ShortType the reference refers to (e.g. "Patient")
                                                                                  Comments

                                                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                  Control0..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                  Aa resource (or, for logical models, the URI of the logical model).

                                                                                  Typeuri
                                                                                  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()))
                                                                                  114. Composition.attester.party.identifier
                                                                                  Definition

                                                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                  ShortLogical reference, when literal reference is not known
                                                                                  Comments

                                                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                  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()))
                                                                                  116. Composition.attester.party.display
                                                                                  Definition

                                                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                  ShortText alternative for the resource
                                                                                  Comments

                                                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                  Control0..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()))
                                                                                  118. Composition.attester:legalAuthenticator
                                                                                  Slice NamelegalAuthenticator
                                                                                  Definition

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

                                                                                  Shortlegal authenticator
                                                                                  Comments

                                                                                  Only list each attester once.

                                                                                  Control0..1
                                                                                  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()))
                                                                                  120. Composition.attester:legalAuthenticator.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
                                                                                  122. Composition.attester:legalAuthenticator.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())
                                                                                  124. Composition.attester:legalAuthenticator.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())
                                                                                  126. Composition.attester:legalAuthenticator.mode
                                                                                  Definition

                                                                                  The type of attestation the authenticator offers.

                                                                                  Shortpersonal | professional | legal | official
                                                                                  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.

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

                                                                                  Who attested the composition in the specified way.

                                                                                  ShortWho attested the composition
                                                                                  Control1..1
                                                                                  TypeReference(CH Core Patient EPR, RelatedPerson, CH Core Practitioner EPR, CH Core PractitionerRole EPR)
                                                                                  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()))
                                                                                  132. Composition.attester:legalAuthenticator.party.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
                                                                                  134. Composition.attester:legalAuthenticator.party.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())
                                                                                  SlicingThis element introduces a set of slices on Composition.attester.party.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 136. Composition.attester:legalAuthenticator.party.reference
                                                                                    Definition

                                                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                                                    Comments

                                                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ref-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()))
                                                                                    138. Composition.attester:legalAuthenticator.party.type
                                                                                    Definition

                                                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                    ShortType the reference refers to (e.g. "Patient")
                                                                                    Comments

                                                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                    Control0..1
                                                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                    Aa resource (or, for logical models, the URI of the logical model).

                                                                                    Typeuri
                                                                                    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()))
                                                                                    140. Composition.attester:legalAuthenticator.party.identifier
                                                                                    Definition

                                                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                    ShortLogical reference, when literal reference is not known
                                                                                    Comments

                                                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                    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()))
                                                                                    142. Composition.attester:legalAuthenticator.party.display
                                                                                    Definition

                                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                    ShortText alternative for the resource
                                                                                    Comments

                                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                    Control0..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()))
                                                                                    144. Composition.custodian
                                                                                    Definition

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

                                                                                    ShortOrganization 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(CH Core Organization EPR)
                                                                                    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()))
                                                                                    146. Composition.custodian.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.custodian.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())
                                                                                    SlicingThis element introduces a set of slices on Composition.custodian.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 150. Composition.custodian.reference
                                                                                      Definition

                                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                                      Comments

                                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: ref-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()))
                                                                                      152. Composition.custodian.type
                                                                                      Definition

                                                                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                      ShortType the reference refers to (e.g. "Patient")
                                                                                      Comments

                                                                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                      Control0..1
                                                                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                      Aa resource (or, for logical models, the URI of the logical model).

                                                                                      Typeuri
                                                                                      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()))
                                                                                      154. Composition.custodian.identifier
                                                                                      Definition

                                                                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                      ShortLogical reference, when literal reference is not known
                                                                                      Comments

                                                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                      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()))
                                                                                      156. Composition.custodian.display
                                                                                      Definition

                                                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                      ShortText alternative for the resource
                                                                                      Comments

                                                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                      Control0..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()))
                                                                                      158. 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()))
                                                                                      160. 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
                                                                                      162. 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())
                                                                                      164. 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())
                                                                                      166. 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()))
                                                                                      168. Composition.relatesTo.target[x]
                                                                                      Definition

                                                                                      The target composition/document of this relationship.

                                                                                      ShortTarget of the relationship
                                                                                      Control1..1
                                                                                      TypeChoice of: Identifier, Reference(CH IPS 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()))
                                                                                      170. 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()))
                                                                                      172. 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
                                                                                      174. 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())
                                                                                      176. 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())
                                                                                      178. 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()))
                                                                                      180. 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()))
                                                                                      182. 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()))
                                                                                      184. Composition.section
                                                                                      Definition

                                                                                      The root of the sections that make up the composition.

                                                                                      ShortComposition is broken into sections
                                                                                      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:
                                                                                      • pattern @ code
                                                                                      • 186. 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
                                                                                        188. Composition.section.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())
                                                                                        190. 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())
                                                                                        192. 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.

                                                                                        Control0..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()))
                                                                                        194. 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.

                                                                                        Control0..1
                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                        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()))
                                                                                        196. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                        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()))
                                                                                        198. 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()))
                                                                                        200. 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.

                                                                                        Control0..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()))
                                                                                        202. 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()))
                                                                                        204. 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)

                                                                                        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()))
                                                                                        206. 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()))
                                                                                        208. 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)

                                                                                        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()))
                                                                                        210. 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..*
                                                                                        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:originalRepresentation
                                                                                        Slice NameoriginalRepresentation
                                                                                        Definition

                                                                                        The root of the sections that make up the composition.

                                                                                        ShortContains the original representation as a PDF of the current document.
                                                                                        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()))
                                                                                        214. Composition.section:originalRepresentation.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
                                                                                        216. Composition.section:originalRepresentation.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())
                                                                                        218. Composition.section:originalRepresentation.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())
                                                                                        220. Composition.section:originalRepresentation.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.

                                                                                        ShortOriginal representation
                                                                                        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()))
                                                                                        222. Composition.section:originalRepresentation.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)

                                                                                        Classification of a section of a composition/document.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Provides computable standardized labels to topics within the document.

                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://loinc.org",
                                                                                            "code" : "55108-5"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        224. Composition.section:originalRepresentation.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(CH Core Practitioner, CH Core PractitionerRole, Device, CH Core Patient, RelatedPerson, CH Core 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()))
                                                                                        226. Composition.section:originalRepresentation.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()))
                                                                                        228. Composition.section:originalRepresentation.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.

                                                                                        ShortRepresentation of the original view
                                                                                        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()))
                                                                                        230. Composition.section:originalRepresentation.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()))
                                                                                        232. Composition.section:originalRepresentation.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)

                                                                                        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()))
                                                                                        234. Composition.section:originalRepresentation.entry
                                                                                        Definition

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

                                                                                        ShortAccording to the EPR ordonnance the PDF has to be in PDF/A-1 or PDF/A-2 format.
                                                                                        Comments

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

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        TypeReference(Binary)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        236. Composition.section:originalRepresentation.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)

                                                                                        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:originalRepresentation.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:sectionMedications
                                                                                        Slice NamesectionMedications
                                                                                        Definition

                                                                                        The root of the sections that make up the composition.

                                                                                        ShortComposition is broken into sections
                                                                                        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()))
                                                                                        242. 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
                                                                                        244. Composition.section:sectionMedications.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())
                                                                                        246. 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())
                                                                                        248. 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.

                                                                                        Control0..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()))
                                                                                        250. 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)

                                                                                        Classification of a section of a composition/document.

                                                                                        TypeCodeableConcept
                                                                                        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()))
                                                                                        252. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                        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()))
                                                                                        254. 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()))
                                                                                        256. 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.

                                                                                        Control0..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()))
                                                                                        258. 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()))
                                                                                        260. 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)

                                                                                        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()))
                                                                                        262. Composition.section:sectionMedications.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()))
                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • profile @ resolve()
                                                                                        • 264. Composition.section:sectionMedications.entry:medicationStatement
                                                                                          Slice NamemedicationStatement
                                                                                          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(CH IPS MedicationStatement)
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          266. Composition.section:sectionMedications.entry:medicationRequest
                                                                                          Slice NamemedicationRequest
                                                                                          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(CH IPS MedicationRequest)
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          268. 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)

                                                                                          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()))
                                                                                          270. 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..*
                                                                                          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()))
                                                                                          272. Composition.section:sectionAllergies
                                                                                          Slice NamesectionAllergies
                                                                                          Definition

                                                                                          The root of the sections that make up the composition.

                                                                                          ShortComposition is broken into sections
                                                                                          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()))
                                                                                          274. 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
                                                                                          276. Composition.section:sectionAllergies.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())
                                                                                          278. 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())
                                                                                          280. 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.

                                                                                          Control0..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: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)

                                                                                          Classification of a section of a composition/document.

                                                                                          TypeCodeableConcept
                                                                                          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()))
                                                                                          284. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                          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: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()))
                                                                                          288. 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.

                                                                                          Control0..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: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()))
                                                                                          292. 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)

                                                                                          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:sectionAllergies.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()))
                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • profile @ resolve()
                                                                                          • 296. Composition.section:sectionAllergies.entry:allergyOrIntolerance
                                                                                            Slice NameallergyOrIntolerance
                                                                                            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(CH IPS AllergyIntolerance)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            298. 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)

                                                                                            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: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..*
                                                                                            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:sectionProblems
                                                                                            Slice NamesectionProblems
                                                                                            Definition

                                                                                            The root of the sections that make up the composition.

                                                                                            ShortComposition is broken into sections
                                                                                            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()))
                                                                                            304. 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
                                                                                            306. Composition.section:sectionProblems.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())
                                                                                            308. 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())
                                                                                            310. 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.

                                                                                            Control0..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()))
                                                                                            312. 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)

                                                                                            Classification of a section of a composition/document.

                                                                                            TypeCodeableConcept
                                                                                            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()))
                                                                                            314. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                            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()))
                                                                                            316. 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()))
                                                                                            318. 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.

                                                                                            Control0..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()))
                                                                                            320. 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()))
                                                                                            322. 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)

                                                                                            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()))
                                                                                            324. Composition.section:sectionProblems.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()))
                                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • profile @ resolve()
                                                                                            • 326. Composition.section:sectionProblems.entry:problem
                                                                                              Slice Nameproblem
                                                                                              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(CH IPS Condition)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              328. 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)

                                                                                              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()))
                                                                                              330. 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..*
                                                                                              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()))
                                                                                              332. Composition.section:sectionProceduresHx
                                                                                              Slice NamesectionProceduresHx
                                                                                              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()))
                                                                                              334. 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
                                                                                              336. Composition.section:sectionProceduresHx.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())
                                                                                              338. 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())
                                                                                              340. 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.

                                                                                              Control0..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()))
                                                                                              342. 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)

                                                                                              Classification of a section of a composition/document.

                                                                                              TypeCodeableConcept
                                                                                              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()))
                                                                                              344. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                              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()))
                                                                                              346. 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()))
                                                                                              348. 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.

                                                                                              Control0..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()))
                                                                                              350. 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()))
                                                                                              352. 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)

                                                                                              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()))
                                                                                              354. Composition.section:sectionProceduresHx.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()))
                                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • profile @ resolve()
                                                                                              • 356. Composition.section:sectionProceduresHx.entry:procedure
                                                                                                Slice Nameprocedure
                                                                                                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(Procedure (IPS))
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                358. 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)

                                                                                                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()))
                                                                                                360. 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..*
                                                                                                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()))
                                                                                                362. Composition.section:sectionImmunizations
                                                                                                Slice NamesectionImmunizations
                                                                                                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()))
                                                                                                364. 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
                                                                                                366. Composition.section:sectionImmunizations.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())
                                                                                                368. 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())
                                                                                                370. 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.

                                                                                                Control0..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()))
                                                                                                372. 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)

                                                                                                Classification of a section of a composition/document.

                                                                                                TypeCodeableConcept
                                                                                                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()))
                                                                                                374. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                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()))
                                                                                                376. 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()))
                                                                                                378. 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.

                                                                                                Control0..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()))
                                                                                                380. 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()))
                                                                                                382. 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)

                                                                                                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()))
                                                                                                384. Composition.section:sectionImmunizations.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()))
                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • profile @ resolve()
                                                                                                • 386. Composition.section:sectionImmunizations.entry:immunization
                                                                                                  Slice Nameimmunization
                                                                                                  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(CH IPS Immunization)
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  388. 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)

                                                                                                  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()))
                                                                                                  390. 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..*
                                                                                                  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()))
                                                                                                  392. Composition.section:sectionMedicalDevices
                                                                                                  Slice NamesectionMedicalDevices
                                                                                                  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()))
                                                                                                  394. 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
                                                                                                  396. Composition.section:sectionMedicalDevices.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())
                                                                                                  398. 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())
                                                                                                  400. 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.

                                                                                                  Control0..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()))
                                                                                                  402. 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)

                                                                                                  Classification of a section of a composition/document.

                                                                                                  TypeCodeableConcept
                                                                                                  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()))
                                                                                                  404. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                  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()))
                                                                                                  406. 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()))
                                                                                                  408. 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.

                                                                                                  Control0..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()))
                                                                                                  410. 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()))
                                                                                                  412. 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)

                                                                                                  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()))
                                                                                                  414. Composition.section:sectionMedicalDevices.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()))
                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • profile @ resolve()
                                                                                                  • 416. Composition.section:sectionMedicalDevices.entry:deviceStatement
                                                                                                    Slice NamedeviceStatement
                                                                                                    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(Device Use Statement (IPS))
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    418. 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)

                                                                                                    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()))
                                                                                                    420. 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..*
                                                                                                    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()))
                                                                                                    422. Composition.section:sectionResults
                                                                                                    Slice NamesectionResults
                                                                                                    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()))
                                                                                                    424. 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
                                                                                                    426. Composition.section:sectionResults.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())
                                                                                                    428. 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())
                                                                                                    430. 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.

                                                                                                    Control0..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()))
                                                                                                    432. 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)

                                                                                                    Classification of a section of a composition/document.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "30954-2"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    434. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                    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()))
                                                                                                    436. 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()))
                                                                                                    438. 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.

                                                                                                    Control0..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()))
                                                                                                    440. 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()))
                                                                                                    442. 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)

                                                                                                    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()))
                                                                                                    444. 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()))
                                                                                                    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()
                                                                                                    • profile @ resolve()
                                                                                                    • 446. Composition.section:sectionResults.entry:resultsObservationLaboratoryPathology
                                                                                                      Slice NameresultsObservationLaboratoryPathology
                                                                                                      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 Results: laboratory/pathology (IPS))
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      448. Composition.section:sectionResults.entry:resultsObservationRadiology
                                                                                                      Slice NameresultsObservationRadiology
                                                                                                      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 Results: radiology (IPS))
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      450. Composition.section:sectionResults.entry:resultsDiagnosticReport
                                                                                                      Slice NameresultsDiagnosticReport
                                                                                                      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(DiagnosticReport (IPS))
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      452. 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)

                                                                                                      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()))
                                                                                                      454. 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..*
                                                                                                      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()))
                                                                                                      456. Composition.section:sectionVitalSigns
                                                                                                      Slice NamesectionVitalSigns
                                                                                                      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()))
                                                                                                      458. 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
                                                                                                      460. Composition.section:sectionVitalSigns.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())
                                                                                                      462. 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())
                                                                                                      464. 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.

                                                                                                      Control0..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()))
                                                                                                      466. 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)

                                                                                                      Classification of a section of a composition/document.

                                                                                                      TypeCodeableConcept
                                                                                                      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()))
                                                                                                      468. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                      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()))
                                                                                                      470. 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()))
                                                                                                      472. 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.

                                                                                                      Control0..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()))
                                                                                                      474. 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()))
                                                                                                      476. 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)

                                                                                                      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()))
                                                                                                      478. Composition.section:sectionVitalSigns.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()))
                                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • profile @ resolve()
                                                                                                      • 480. Composition.section:sectionVitalSigns.entry:vitalSign
                                                                                                        Slice NamevitalSign
                                                                                                        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(Vital Signs Profile)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        482. 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)

                                                                                                        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()))
                                                                                                        484. 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..*
                                                                                                        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()))
                                                                                                        486. Composition.section:sectionPastIllnessHx
                                                                                                        Slice NamesectionPastIllnessHx
                                                                                                        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()))
                                                                                                        488. Composition.section:sectionPastIllnessHx.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
                                                                                                        490. Composition.section:sectionPastIllnessHx.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())
                                                                                                        492. Composition.section:sectionPastIllnessHx.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())
                                                                                                        494. Composition.section:sectionPastIllnessHx.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.

                                                                                                        Control0..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()))
                                                                                                        496. Composition.section:sectionPastIllnessHx.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)

                                                                                                        Classification of a section of a composition/document.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://loinc.org",
                                                                                                            "code" : "11348-0"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        498. Composition.section:sectionPastIllnessHx.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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                        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()))
                                                                                                        500. Composition.section:sectionPastIllnessHx.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()))
                                                                                                        502. Composition.section:sectionPastIllnessHx.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.

                                                                                                        Control0..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()))
                                                                                                        504. Composition.section:sectionPastIllnessHx.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()))
                                                                                                        506. Composition.section:sectionPastIllnessHx.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)

                                                                                                        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()))
                                                                                                        508. Composition.section:sectionPastIllnessHx.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()))
                                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • profile @ resolve()
                                                                                                        • 510. Composition.section:sectionPastIllnessHx.entry:pastProblem
                                                                                                          Slice NamepastProblem
                                                                                                          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(CH IPS Condition)
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          512. Composition.section:sectionPastIllnessHx.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)

                                                                                                          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()))
                                                                                                          514. Composition.section:sectionPastIllnessHx.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..*
                                                                                                          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()))
                                                                                                          516. Composition.section:sectionFunctionalStatus
                                                                                                          Slice NamesectionFunctionalStatus
                                                                                                          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()))
                                                                                                          518. 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
                                                                                                          520. Composition.section:sectionFunctionalStatus.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())
                                                                                                          522. 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())
                                                                                                          524. 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.

                                                                                                          Control0..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()))
                                                                                                          526. 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)

                                                                                                          Classification of a section of a composition/document.

                                                                                                          TypeCodeableConcept
                                                                                                          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()))
                                                                                                          528. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                          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()))
                                                                                                          530. 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()))
                                                                                                          532. 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.

                                                                                                          Control0..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()))
                                                                                                          534. 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()))
                                                                                                          536. 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)

                                                                                                          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()))
                                                                                                          538. Composition.section:sectionFunctionalStatus.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()))
                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • profile @ resolve()
                                                                                                          • 540. Composition.section:sectionFunctionalStatus.entry:disability
                                                                                                            Slice Namedisability
                                                                                                            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(CH IPS Condition)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            542. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
                                                                                                            Slice NamefunctionalAssessment
                                                                                                            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(ClinicalImpression)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            544. 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)

                                                                                                            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()))
                                                                                                            546. 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..*
                                                                                                            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()))
                                                                                                            548. Composition.section:sectionPlanOfCare
                                                                                                            Slice NamesectionPlanOfCare
                                                                                                            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()))
                                                                                                            550. 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
                                                                                                            552. Composition.section:sectionPlanOfCare.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())
                                                                                                            554. 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())
                                                                                                            556. 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.

                                                                                                            Control0..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()))
                                                                                                            558. 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)

                                                                                                            Classification of a section of a composition/document.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Provides computable standardized labels to topics within the document.

                                                                                                            Pattern Value{
                                                                                                              "coding" : [{
                                                                                                                "system" : "http://loinc.org",
                                                                                                                "code" : "18776-5"
                                                                                                              }]
                                                                                                            }
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            560. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                            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()))
                                                                                                            562. 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()))
                                                                                                            564. 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.

                                                                                                            Control0..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()))
                                                                                                            566. 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()))
                                                                                                            568. 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)

                                                                                                            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()))
                                                                                                            570. 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()))
                                                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • profile @ resolve()
                                                                                                            • 572. Composition.section:sectionPlanOfCare.entry:carePlan
                                                                                                              Slice NamecarePlan
                                                                                                              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(CarePlan)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              574. 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)

                                                                                                              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()))
                                                                                                              576. 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..*
                                                                                                              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()))
                                                                                                              578. Composition.section:sectionSocialHistory
                                                                                                              Slice NamesectionSocialHistory
                                                                                                              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()))
                                                                                                              580. 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
                                                                                                              582. Composition.section:sectionSocialHistory.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())
                                                                                                              584. 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())
                                                                                                              586. 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.

                                                                                                              Control0..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()))
                                                                                                              588. 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)

                                                                                                              Classification of a section of a composition/document.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Provides computable standardized labels to topics within the document.

                                                                                                              Pattern Value{
                                                                                                                "coding" : [{
                                                                                                                  "system" : "http://loinc.org",
                                                                                                                  "code" : "29762-2"
                                                                                                                }]
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              590. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                              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()))
                                                                                                              592. 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()))
                                                                                                              594. 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.

                                                                                                              Control0..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()))
                                                                                                              596. 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()))
                                                                                                              598. 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)

                                                                                                              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()))
                                                                                                              600. 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()))
                                                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • profile @ resolve()
                                                                                                              • 602. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
                                                                                                                Slice NamesmokingTobaccoUse
                                                                                                                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(Observation - SH: tobacco use)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                604. Composition.section:sectionSocialHistory.entry:alcoholUse
                                                                                                                Slice NamealcoholUse
                                                                                                                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(Observation - SH: alcohol use)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                606. 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)

                                                                                                                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()))
                                                                                                                608. 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..*
                                                                                                                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()))
                                                                                                                610. Composition.section:sectionPregnancyHx
                                                                                                                Slice NamesectionPregnancyHx
                                                                                                                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()))
                                                                                                                612. 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
                                                                                                                614. Composition.section:sectionPregnancyHx.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())
                                                                                                                616. 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())
                                                                                                                618. 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.

                                                                                                                Control0..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()))
                                                                                                                620. 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)

                                                                                                                Classification of a section of a composition/document.

                                                                                                                TypeCodeableConcept
                                                                                                                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()))
                                                                                                                622. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                                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()))
                                                                                                                624. 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()))
                                                                                                                626. 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.

                                                                                                                Control0..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()))
                                                                                                                628. 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()))
                                                                                                                630. 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)

                                                                                                                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()))
                                                                                                                632. Composition.section:sectionPregnancyHx.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()))
                                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • profile @ resolve()
                                                                                                                • 634. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
                                                                                                                  Slice NamepregnancyStatus
                                                                                                                  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 - Pregnancy: status)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  636. Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
                                                                                                                  Slice NamepregnancyOutcomeSummary
                                                                                                                  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 - Pregnancy: outcome)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  638. 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)

                                                                                                                  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()))
                                                                                                                  640. 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..*
                                                                                                                  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()))
                                                                                                                  642. Composition.section:sectionAdvanceDirectives
                                                                                                                  Slice NamesectionAdvanceDirectives
                                                                                                                  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()))
                                                                                                                  644. 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
                                                                                                                  646. Composition.section:sectionAdvanceDirectives.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())
                                                                                                                  648. 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())
                                                                                                                  650. 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.

                                                                                                                  Control0..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()))
                                                                                                                  652. 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)

                                                                                                                  Classification of a section of a composition/document.

                                                                                                                  TypeCodeableConcept
                                                                                                                  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()))
                                                                                                                  654. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                                  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()))
                                                                                                                  656. 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()))
                                                                                                                  658. 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.

                                                                                                                  Control0..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()))
                                                                                                                  660. 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()))
                                                                                                                  662. 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)

                                                                                                                  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()))
                                                                                                                  664. 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(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:
                                                                                                                  • profile @ resolve()
                                                                                                                  • 666. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
                                                                                                                    Slice NameadvanceDirectivesConsent
                                                                                                                    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)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    668. 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)

                                                                                                                    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()))
                                                                                                                    670. 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..*
                                                                                                                    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()))
                                                                                                                    672. 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()))
                                                                                                                    674. 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
                                                                                                                    676. Composition.section:sectionAlerts.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())
                                                                                                                    678. 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())
                                                                                                                    680. 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.

                                                                                                                    Control0..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()))
                                                                                                                    682. 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)

                                                                                                                    Classification of a section of a composition/document.

                                                                                                                    TypeCodeableConcept
                                                                                                                    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()))
                                                                                                                    684. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                                    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()))
                                                                                                                    686. 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()))
                                                                                                                    688. 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.

                                                                                                                    Control0..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()))
                                                                                                                    690. 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()))
                                                                                                                    692. 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)

                                                                                                                    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()))
                                                                                                                    694. 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()))
                                                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • profile @ resolve()
                                                                                                                    • 696. Composition.section:sectionAlerts.entry:alertsFlag
                                                                                                                      Slice NamealertsFlag
                                                                                                                      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(Flag - Alert (IPS))
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      698. 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)

                                                                                                                      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()))
                                                                                                                      700. 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..*
                                                                                                                      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()))
                                                                                                                      702. 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()))
                                                                                                                      704. 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
                                                                                                                      706. Composition.section:sectionPatientStory.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())
                                                                                                                      708. 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())
                                                                                                                      710. 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.

                                                                                                                      Control0..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()))
                                                                                                                      712. 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)

                                                                                                                      Classification of a section of a composition/document.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Provides computable standardized labels to topics within the document.

                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "81338-6"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      714. 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(CH Core Practitioner EPR, CH Core PractitionerRole EPR, Device, CH Core Patient EPR, RelatedPerson, CH Core Organization EPR)
                                                                                                                      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()))
                                                                                                                      716. 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()))
                                                                                                                      718. 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.

                                                                                                                      Control0..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()))
                                                                                                                      720. 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()))
                                                                                                                      722. 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)

                                                                                                                      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()))
                                                                                                                      724. 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()))
                                                                                                                      726. 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)

                                                                                                                      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()))
                                                                                                                      728. 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..*
                                                                                                                      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()))