HL7 Europe Imaging Study Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.eu/fhir/imaging-r5/StructureDefinition/Report-EuDocumentReference | Version: 0.1.0-build | |||
| Draft as of 2025-08-20 | Computable Name: Report_EuDocumentReference | |||
| Copyright/Legal: Used by permission of HL7 Europe, all rights reserved Creative Commons License | ||||
Report obligations for EuDocumentReference
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints    Filter:   | ||||
|---|---|---|---|---|---|---|---|---|
|   DocumentReference | C | 0..* | DocumentReferenceEu | A reference to a document Constraints: docRef-1, docRef-2 | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    Slices for extension | Content/Rules for all slices | |||||||
|     extension:note | O | 0..1 | Annotation | Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note 
 | ||||
|     extension:view | O | 0..1 | CodeableConcept | Media.view extension URL: http://hl7.eu/fhir/imaging-r5/StructureDefinition/CrossVersionMediaViewExtension Binding: Media View types - placeholder for cross-version extension (required) 
 | ||||
|    modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | OΣ | 0..* | Identifier | Business identifiers for the document 
 | ||||
|    status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. | ||||
|    modality | OΣ | 0..* | CodeableConcept | Imaging modality used Binding: Modality (extensible): Type of acquired data in the instance. 
 | ||||
|    type | OΣ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document. 
 | ||||
|    subject | OΣ | 0..1 | Reference(Resource) | Who/what is the subject of the document 
 | ||||
|    context | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content | ||||
|    period | OΣ | 0..1 | Period | Time of service that is being documented 
 | ||||
|    author | OΣ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) | Who and/or what authored the document 
 | ||||
|    content | Σ | 1..* | BackboneElement | Document referenced | ||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     attachment | OΣ | 1..1 | Attachment | Where to access the document 
 | ||||
|  Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | 
| DocumentReference.status | required | DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0From the FHIR Standard | |
| DocumentReference.modality | extensible | Modality (missing link) http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.htmlFrom this IG | |
| DocumentReference.type | preferred | FHIRDocumentTypeCodes http://hl7.org/fhir/ValueSet/doc-typecodesFrom the FHIR Standard | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | DocumentReference | A resource should have narrative for robust management : text.`div`.exists() | |
| docRef-1 | warning | DocumentReference | facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty() | |
| docRef-2 | warning | DocumentReference | practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | 
This structure is derived from DocumentReferenceEu
| Name | Flags | Card. | Type | Description & Constraints    Filter:   | ||||
|---|---|---|---|---|---|---|---|---|
|   DocumentReference | C | 0..* | DocumentReferenceEu | A reference to a document Constraints: docRef-1, docRef-2 | ||||
|    id | Σ | 0..1 | id | Logical id of this artifact | ||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    language | 0..1 | code | Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language 
 | |||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
|     extension:note | O | 0..1 | Annotation | Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note 
 | ||||
|     extension:view | O | 0..1 | CodeableConcept | Media.view extension URL: http://hl7.eu/fhir/imaging-r5/StructureDefinition/CrossVersionMediaViewExtension Binding: Media View types - placeholder for cross-version extension (required) 
 | ||||
|    modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | OΣ | 0..* | Identifier | Business identifiers for the document 
 | ||||
|    version | Σ | 0..1 | string | An explicitly assigned identifer of a variation of the content in the DocumentReference | ||||
|    basedOn | 0..* | Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) | Procedure that caused this media to be created | |||||
|    status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. | ||||
|    docStatus | Σ | 0..1 | code | registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: CompositionStatus (required): Status of the underlying document. | ||||
|    modality | OΣ | 0..* | CodeableConcept | Imaging modality used Binding: Modality (extensible): Type of acquired data in the instance. 
 | ||||
|    type | OΣ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document. 
 | ||||
|    category | Σ | 0..* | CodeableConcept | Categorization of document Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level. | ||||
|    subject | OΣ | 0..1 | Reference(Resource) | Who/what is the subject of the document 
 | ||||
|    context | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content | ||||
|    event | 0..* | CodeableReference() | Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. | |||||
|    bodySite | Σ | 0..* | CodeableReference(BodyStructure) | Body part included Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts | ||||
|     id | 0..1 | id | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
|     concept | OΣ | 0..1 | CodeableConcept | Reference to a concept (by class) 
 | ||||
|     reference | Σ | 0..1 | Reference() | Reference to a resource (by instance) | ||||
|    facilityType | C | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type. | ||||
|    practiceSetting | C | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty). | ||||
|    period | OΣ | 0..1 | Period | Time of service that is being documented 
 | ||||
|    date | Σ | 0..1 | instant | When this document reference was created | ||||
|    author | OΣ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) | Who and/or what authored the document 
 | ||||
|    attester | 0..* | BackboneElement | Attests to accuracy of the document | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     mode | 1..1 | CodeableConcept | personal | professional | legal | official Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document. | |||||
|     time | 0..1 | dateTime | When the document was attested | |||||
|     party | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) | Who attested the document | |||||
|    custodian | 0..1 | Reference(Organization) | Organization which maintains the document | |||||
|    relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     code | Σ | 1..1 | CodeableConcept | The relationship type with another document Binding: DocumentRelationshipType (extensible): The type of relationship between the documents. | ||||
|     target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship | ||||
|    description | Σ | 0..1 | markdown | Human-readable description | ||||
|    securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System. | ||||
|    content | Σ | 1..* | BackboneElement | Document referenced | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     attachment | OΣ | 1..1 | Attachment | Where to access the document 
 | ||||
|     profile | Σ | 0..* | BackboneElement | Content profile rules for the document | ||||
|      id | 0..1 | string | Unique id for inter-element referencing | |||||
|      extension | 0..* | Extension | Additional content defined by implementations | |||||
|      modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|      value[x] | Σ | 1..1 | Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes. | |||||
|       valueCoding | Coding | |||||||
|       valueUri | uri | |||||||
|       valueCanonical | canonical(Any) | |||||||
|  Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | 
| DocumentReference.language | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0From the FHIR Standard | |
| DocumentReference.status | required | DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0From the FHIR Standard | |
| DocumentReference.docStatus | required | CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|5.0.0From the FHIR Standard | |
| DocumentReference.modality | extensible | Modality (missing link) http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.htmlFrom this IG | |
| DocumentReference.type | preferred | FHIRDocumentTypeCodes http://hl7.org/fhir/ValueSet/doc-typecodesFrom the FHIR Standard | |
| DocumentReference.category | example | ReferencedItemCategoryValueSet http://hl7.org/fhir/ValueSet/referenced-item-categoryFrom the FHIR Standard | |
| DocumentReference.event | example | ActCode http://terminology.hl7.org/ValueSet/v3-ActCode | |
| DocumentReference.bodySite | example | SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-siteFrom the FHIR Standard | |
| DocumentReference.facilityType | example | FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodesFrom the FHIR Standard | |
| DocumentReference.practiceSetting | example | PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codesFrom the FHIR Standard | |
| DocumentReference.attester.mode | preferred | CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-modeFrom the FHIR Standard | |
| DocumentReference.relatesTo.code | extensible | DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-typeFrom the FHIR Standard | |
| DocumentReference.securityLabel | example | SecurityLabelExamples http://hl7.org/fhir/ValueSet/security-label-examplesFrom the FHIR Standard | |
| DocumentReference.content.profile.value[x] | preferred | HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | DocumentReference | A resource should have narrative for robust management : text.`div`.exists() | |
| docRef-1 | warning | DocumentReference | facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty() | |
| docRef-2 | warning | DocumentReference | practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | 
This structure is derived from DocumentReferenceEu
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints    Filter:   | ||||
|---|---|---|---|---|---|---|---|---|
|   DocumentReference | C | 0..* | DocumentReferenceEu | A reference to a document Constraints: docRef-1, docRef-2 | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    Slices for extension | Content/Rules for all slices | |||||||
|     extension:note | O | 0..1 | Annotation | Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note 
 | ||||
|     extension:view | O | 0..1 | CodeableConcept | Media.view extension URL: http://hl7.eu/fhir/imaging-r5/StructureDefinition/CrossVersionMediaViewExtension Binding: Media View types - placeholder for cross-version extension (required) 
 | ||||
|    modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | OΣ | 0..* | Identifier | Business identifiers for the document 
 | ||||
|    status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. | ||||
|    modality | OΣ | 0..* | CodeableConcept | Imaging modality used Binding: Modality (extensible): Type of acquired data in the instance. 
 | ||||
|    type | OΣ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document. 
 | ||||
|    subject | OΣ | 0..1 | Reference(Resource) | Who/what is the subject of the document 
 | ||||
|    context | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content | ||||
|    period | OΣ | 0..1 | Period | Time of service that is being documented 
 | ||||
|    author | OΣ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) | Who and/or what authored the document 
 | ||||
|    content | Σ | 1..* | BackboneElement | Document referenced | ||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     attachment | OΣ | 1..1 | Attachment | Where to access the document 
 | ||||
|  Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | 
| DocumentReference.status | required | DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0From the FHIR Standard | |
| DocumentReference.modality | extensible | Modality (missing link) http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.htmlFrom this IG | |
| DocumentReference.type | preferred | FHIRDocumentTypeCodes http://hl7.org/fhir/ValueSet/doc-typecodesFrom the FHIR Standard | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | DocumentReference | A resource should have narrative for robust management : text.`div`.exists() | |
| docRef-1 | warning | DocumentReference | facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty() | |
| docRef-2 | warning | DocumentReference | practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | 
Differential View
This structure is derived from DocumentReferenceEu
| Name | Flags | Card. | Type | Description & Constraints    Filter:   | ||||
|---|---|---|---|---|---|---|---|---|
|   DocumentReference | 0..* | DocumentReferenceEu | A reference to a document | |||||
|    Slices for extension | Content/Rules for all slices | |||||||
|     extension:note | O | 0..1 | Note(5.2.0) | Additional notes that apply to this resource or element. 
 | ||||
|     extension:view | O | 0..1 | CrossVersionMediaViewExtension | Media.view extension 
 | ||||
|    identifier | O | 0..* | Identifier | Business identifiers for the document 
 | ||||
|    modality | O | 0..* | CodeableConcept | Imaging modality used 
 | ||||
|    type | O | 0..1 | CodeableConcept | Kind of document (LOINC if possible) 
 | ||||
|    subject | O | 0..1 | Reference(Resource) | Who/what is the subject of the document 
 | ||||
|    bodySite | ||||||||
|     concept | O | 0..1 | CodeableConcept | Reference to a concept (by class) 
 | ||||
|    period | O | 0..1 | Period | Time of service that is being documented 
 | ||||
|    author | O | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) | Who and/or what authored the document 
 | ||||
|    content | ||||||||
|     attachment | O | 1..1 | Attachment | Where to access the document 
 | ||||
|  Documentation for this format | ||||||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints    Filter:   | ||||
|---|---|---|---|---|---|---|---|---|
|   DocumentReference | C | 0..* | DocumentReferenceEu | A reference to a document Constraints: docRef-1, docRef-2 | ||||
|    id | Σ | 0..1 | id | Logical id of this artifact | ||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    language | 0..1 | code | Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language 
 | |||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
|     extension:note | O | 0..1 | Annotation | Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note 
 | ||||
|     extension:view | O | 0..1 | CodeableConcept | Media.view extension URL: http://hl7.eu/fhir/imaging-r5/StructureDefinition/CrossVersionMediaViewExtension Binding: Media View types - placeholder for cross-version extension (required) 
 | ||||
|    modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | OΣ | 0..* | Identifier | Business identifiers for the document 
 | ||||
|    version | Σ | 0..1 | string | An explicitly assigned identifer of a variation of the content in the DocumentReference | ||||
|    basedOn | 0..* | Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) | Procedure that caused this media to be created | |||||
|    status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. | ||||
|    docStatus | Σ | 0..1 | code | registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: CompositionStatus (required): Status of the underlying document. | ||||
|    modality | OΣ | 0..* | CodeableConcept | Imaging modality used Binding: Modality (extensible): Type of acquired data in the instance. 
 | ||||
|    type | OΣ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document. 
 | ||||
|    category | Σ | 0..* | CodeableConcept | Categorization of document Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level. | ||||
|    subject | OΣ | 0..1 | Reference(Resource) | Who/what is the subject of the document 
 | ||||
|    context | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content | ||||
|    event | 0..* | CodeableReference() | Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. | |||||
|    bodySite | Σ | 0..* | CodeableReference(BodyStructure) | Body part included Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts | ||||
|     id | 0..1 | id | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
|     concept | OΣ | 0..1 | CodeableConcept | Reference to a concept (by class) 
 | ||||
|     reference | Σ | 0..1 | Reference() | Reference to a resource (by instance) | ||||
|    facilityType | C | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type. | ||||
|    practiceSetting | C | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty). | ||||
|    period | OΣ | 0..1 | Period | Time of service that is being documented 
 | ||||
|    date | Σ | 0..1 | instant | When this document reference was created | ||||
|    author | OΣ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) | Who and/or what authored the document 
 | ||||
|    attester | 0..* | BackboneElement | Attests to accuracy of the document | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     mode | 1..1 | CodeableConcept | personal | professional | legal | official Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document. | |||||
|     time | 0..1 | dateTime | When the document was attested | |||||
|     party | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) | Who attested the document | |||||
|    custodian | 0..1 | Reference(Organization) | Organization which maintains the document | |||||
|    relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     code | Σ | 1..1 | CodeableConcept | The relationship type with another document Binding: DocumentRelationshipType (extensible): The type of relationship between the documents. | ||||
|     target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship | ||||
|    description | Σ | 0..1 | markdown | Human-readable description | ||||
|    securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System. | ||||
|    content | Σ | 1..* | BackboneElement | Document referenced | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     attachment | OΣ | 1..1 | Attachment | Where to access the document 
 | ||||
|     profile | Σ | 0..* | BackboneElement | Content profile rules for the document | ||||
|      id | 0..1 | string | Unique id for inter-element referencing | |||||
|      extension | 0..* | Extension | Additional content defined by implementations | |||||
|      modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|      value[x] | Σ | 1..1 | Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes. | |||||
|       valueCoding | Coding | |||||||
|       valueUri | uri | |||||||
|       valueCanonical | canonical(Any) | |||||||
|  Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | 
| DocumentReference.language | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0From the FHIR Standard | |
| DocumentReference.status | required | DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0From the FHIR Standard | |
| DocumentReference.docStatus | required | CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|5.0.0From the FHIR Standard | |
| DocumentReference.modality | extensible | Modality (missing link) http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.htmlFrom this IG | |
| DocumentReference.type | preferred | FHIRDocumentTypeCodes http://hl7.org/fhir/ValueSet/doc-typecodesFrom the FHIR Standard | |
| DocumentReference.category | example | ReferencedItemCategoryValueSet http://hl7.org/fhir/ValueSet/referenced-item-categoryFrom the FHIR Standard | |
| DocumentReference.event | example | ActCode http://terminology.hl7.org/ValueSet/v3-ActCode | |
| DocumentReference.bodySite | example | SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-siteFrom the FHIR Standard | |
| DocumentReference.facilityType | example | FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodesFrom the FHIR Standard | |
| DocumentReference.practiceSetting | example | PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codesFrom the FHIR Standard | |
| DocumentReference.attester.mode | preferred | CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-modeFrom the FHIR Standard | |
| DocumentReference.relatesTo.code | extensible | DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-typeFrom the FHIR Standard | |
| DocumentReference.securityLabel | example | SecurityLabelExamples http://hl7.org/fhir/ValueSet/security-label-examplesFrom the FHIR Standard | |
| DocumentReference.content.profile.value[x] | preferred | HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | DocumentReference | A resource should have narrative for robust management : text.`div`.exists() | |
| docRef-1 | warning | DocumentReference | facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty() | |
| docRef-2 | warning | DocumentReference | practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | 
This structure is derived from DocumentReferenceEu
Other representations of profile: CSV, Excel, Schematron