description: The US Core Advance Directive Information (ADI) DocumentReference Profile inherits from the FHIR [DocumentReference](https://hl7.org/fhir/R4/documentreference.html) resource; refer to it for scope and usage definitions. It sets minimum expectations for searching and fetching patient Advance Directive Information (ADI) documents using the DocumentReference resource. Examples of advance healthcare directive documents include physician order for life sustaining treatment (POLST), do not resuscitate order (DNR), and medical power of attorney. In addition to the document contents, it communicates the type of advance directive document, the author, the verifier, and other properties. To represent whether advance directive documents exist for a patient, see the [US Core Observation ADI Documentation Profile](StructureDefinition-us-core-observation-adi-documentation.html). To represent orders based on an individual's Portable Medical Order (PMO), see the [US Core PMO ServiceRequest Profile](StructureDefinition-us-core-pmo-servicerequest.html). This profile sets minimum expectations for searching and fetching patient ADI documents using the DocumentReference resource. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.
package_name: hl7.fhir.us.core
derivation: constraint
name: USCoreADIDocumentReferenceProfile
type: DocumentReference
elements:
  category:
    mustSupport: true
    index: 4
    slicing:
      rules: open
      discriminator:
      - {path: $this, type: value}
      min: 1
      slices:
        adi:
          match: {}
          schema:
            short: Categorization of ADI document
            binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4'}
            mustSupport: true
            index: 5
  date: {mustSupport: true, index: 7}
  content:
    mustSupport: true
    index: 9
    elements:
      attachment:
        constraint:
          us-core-6: {human: DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present., severity: error, expression: url.exists() or data.exists()}
        mustSupport: true
        index: 10
        elements:
          contentType: {mustSupport: true, index: 11}
          data: {mustSupport: true, index: 12}
          url: {mustSupport: true, index: 13}
      format:
        binding: {strength: extensible, valueSet: 'http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes|2.1.0'}
        mustSupport: true
        index: 14
  type:
    binding: {strength: extensible, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.41'}
    mustSupport: true
    index: 3
  author:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-device', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson']
    index: 8
  extension:
    type: Extension
    short: Participant who has authenticated the accuracy of the document.
    mustSupport: true
    url: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.attester
    index: 0
    slicing:
      slices:
        fhir5-attester:
          match: {}
          schema: {type: Extension, short: Participant who has authenticated the accuracy of the document., mustSupport: true, url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.attester', index: 0}
  status:
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/document-reference-status'}
    mustSupport: true
    index: 2
  identifier: {mustSupport: true, index: 1}
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient']
    index: 6
package_version: 9.0.0-ballot
extensions:
  fhir5-attester: {url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.attester', type: Extension, short: Participant who has authenticated the accuracy of the document., mustSupport: true, index: 0}
class: profile
kind: resource
url: http://hl7.org/fhir/us/core/StructureDefinition/us-core-adi-documentreference
base: http://hl7.org/fhir/StructureDefinition/DocumentReference
version: 9.0.0-ballot
required: [subject, type, category]