PackagesCanonicalsLogsProblems
    Packages
    hl7.fhir.uv.fhir-clinical-document@1.0.0-ballot
    http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/clinical-document-composition
{
  "description": "Starting point for a specification for a composition of a FHIR Clinical Document.",
  "_filename": "StructureDefinition-clinical-document-composition.json",
  "package_name": "hl7.fhir.uv.fhir-clinical-document",
  "date": "2024-08-08T18:14:34+00:00",
  "derivation": "constraint",
  "publisher": "HL7 International / Structured Documents",
  "fhirVersion": "4.0.1",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "name": "ClinicalDocumentComposition",
  "mapping": [ {
    "uri": "http://hl7.org/fhir/workflow",
    "name": "Workflow Pattern",
    "identity": "workflow"
  }, {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  }, {
    "uri": "http://hl7.org/v3/cda",
    "name": "CDA (R2)",
    "identity": "cda"
  }, {
    "uri": "http://hl7.org/fhir/documentreference",
    "name": "FHIR DocumentReference",
    "identity": "fhirdocumentreference"
  }, {
    "uri": "http://hl7.org/fhir/fivews",
    "name": "FiveWs Pattern Mapping",
    "identity": "w5"
  } ],
  "abstract": false,
  "copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
  "type": "Composition",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "FHIR Clinical Document Composition Profile",
  "package_version": "1.0.0-ballot",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "sd"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 2,
    "_valueInteger": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "http://hl7.org/fhir/uv/fhir-clinical-document/ImplementationGuide/hl7.fhir.uv.fhir-clinical-document"
      } ]
    }
  } ],
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-3",
        "human": "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",
        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "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()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-5",
        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.security.empty()"
      }, {
        "key": "dom-6",
        "human": "A resource should have narrative for robust management",
        "xpath": "exists(f:text/h:div)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "warning",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
          "valueBoolean": true
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
          "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
        } ],
        "expression": "text.`div`.exists()"
      }, {
        "key": "clindoc-limit-participantType",
        "human": "FHIR Clinical Document Composition Profile contains fields for AUT, AUTHEN, CST, LA, RCT, SBJ. These types are not allowed as types in the Participant Extension",
        "source": "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/clinical-document-composition",
        "severity": "error",
        "expression": "extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='AUT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='AUTHEN').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='CST').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='LA').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='RCT').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='SBJ').not()"
      } ],
      "path": "Composition",
      "min": 0,
      "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.).",
      "isModifier": false,
      "short": "A set of resources composed into a single coherent clinical statement with clinical attestation",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Event",
        "identity": "workflow"
      }, {
        "map": "Document[classCode=\"DOC\" and moodCode=\"EVN\" and isNormalAct()]",
        "identity": "rim"
      }, {
        "map": "ClinicalDocument",
        "identity": "cda"
      }, {
        "map": "when described by DocumentReference",
        "identity": "fhirdocumentreference"
      } ],
      "max": "*",
      "id": "Composition",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition"
      },
      "isSummary": false
    }, {
      "path": "Composition.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "isModifier": false,
      "short": "Logical id of this artifact",
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "id"
        } ]
      } ],
      "max": "1",
      "id": "Composition.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.meta",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Metadata about the resource",
      "type": [ {
        "code": "Meta"
      } ],
      "max": "1",
      "id": "Composition.meta",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.implicitRules",
      "min": 0,
      "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.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Composition.implicitRules",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isModifierReason": "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",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "isModifier": false,
      "short": "Language of the resource content",
      "mapping": [ {
        "map": "languageCode",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        } ],
        "description": "A human language."
      },
      "max": "1",
      "id": "Composition.language",
      "comment": "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).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.text",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "mustSupport": true,
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Composition.text",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      },
      "isSummary": false
    }, {
      "path": "Composition.contained",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Composition.contained",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "*",
      "id": "Composition.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "Optional Extension Element - found in all resources.",
      "isModifier": false,
      "short": "Optional Extensions Element",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "versionNumber",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version" ]
      } ],
      "mustSupport": true,
      "sliceName": "R5-Composition-version",
      "max": "1",
      "label": "clinical document version number",
      "id": "Composition.extension:R5-Composition-version",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "The Data Enterer Extension represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.",
      "isModifier": false,
      "short": "A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.",
      "mapping": [ {
        "map": "assignedEntity.dataEnterer",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "data-enterer",
      "max": "1",
      "label": "date enterer",
      "id": "Composition.extension:data-enterer",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "Informant Extension describes an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.",
      "isModifier": false,
      "short": "An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.",
      "mapping": [ {
        "map": "informantChoice.informant",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "informant",
      "max": "*",
      "label": "informant",
      "id": "Composition.extension:informant",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "The Information Recipient Extension records the intended recipient of the information at the time the document was created.",
      "isModifier": false,
      "short": "An Information Recipient is the intended recipient of the information at the time the document was created.",
      "mapping": [ {
        "map": "intendedRecipient.informationRecipient",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "information-recipient",
      "max": "*",
      "label": "information recipient of type primary, secondary information recipient or a generic information recipient",
      "id": "Composition.extension:information-recipient",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "Participant Extension identifies supporting entities, including parents, relatives, caregivers, insurance policyholders, guarantors, and others related in some way to the patient. A supporting person or organization is an individual or an organization with a relationship to the patient. A supporting person who is playing multiple roles would be recorded in multiple participants (e.g., emergency contact and next-of-kin).",
      "isModifier": false,
      "short": "A Participant that is not a data-enter, information-recipient nor an informant",
      "mapping": [ {
        "map": "associatedEntity.participant",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension" ]
      } ],
      "mustSupport": true,
      "sliceName": "participant",
      "max": "*",
      "label": "A Participant that is not a data-enter, information-recipient nor an informant",
      "id": "Composition.extension:participant",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "path": "Composition.extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension",
      "min": 2,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "*",
      "id": "Composition.extension:participant.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension",
      "min": 1,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "type": [ {
        "code": "Extension"
      } ],
      "sliceName": "type",
      "max": "*",
      "id": "Composition.extension:participant.extension:type",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:type.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Composition.extension:participant.extension:type.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "type",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:type.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.extension.extension.value[x]",
      "min": 1,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/fhir-clinical-document/ValueSet/clinical-doc-participant-vs",
        "description": "particpants that are not a data-enter, information-recipient nor an informant"
      },
      "max": "1",
      "id": "Composition.extension:participant.extension:type.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Exact function of the participant in the creation of the clinical document. This is more granular than type.",
      "type": [ {
        "code": "Extension"
      } ],
      "sliceName": "function",
      "max": "*",
      "id": "Composition.extension:participant.extension:function",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:function.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Composition.extension:participant.extension:function.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "function",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:function.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.extension.extension.value[x]",
      "min": 1,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://terminology.hl7.org/ValueSet/v3-ParticipationFunction"
      },
      "max": "1",
      "id": "Composition.extension:participant.extension:function.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Time period of participation",
      "type": [ {
        "code": "Extension"
      } ],
      "sliceName": "time",
      "max": "1",
      "id": "Composition.extension:participant.extension:time",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:time.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Composition.extension:participant.extension:time.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "time",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:time.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.extension.extension.value[x]",
      "min": 1,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Composition.extension:participant.extension:time.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension",
      "min": 1,
      "definition": "An Extension",
      "isModifier": false,
      "short": "participant",
      "type": [ {
        "code": "Extension"
      } ],
      "mustSupport": true,
      "sliceName": "party",
      "max": "1",
      "id": "Composition.extension:participant.extension:party",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:party.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Composition.extension:participant.extension:party.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "party",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.extension:party.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.extension.extension.value[x]",
      "min": 1,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Composition.extension:participant.extension:party.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "path": "Composition.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.extension:participant.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.extension.value[x]",
      "min": 0,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "base64Binary"
      }, {
        "code": "boolean"
      }, {
        "code": "canonical"
      }, {
        "code": "code"
      }, {
        "code": "date"
      }, {
        "code": "dateTime"
      }, {
        "code": "decimal"
      }, {
        "code": "id"
      }, {
        "code": "instant"
      }, {
        "code": "integer"
      }, {
        "code": "markdown"
      }, {
        "code": "oid"
      }, {
        "code": "positiveInt"
      }, {
        "code": "string"
      }, {
        "code": "time"
      }, {
        "code": "unsignedInt"
      }, {
        "code": "uri"
      }, {
        "code": "url"
      }, {
        "code": "uuid"
      }, {
        "code": "Address"
      }, {
        "code": "Age"
      }, {
        "code": "Annotation"
      }, {
        "code": "Attachment"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "Coding"
      }, {
        "code": "ContactPoint"
      }, {
        "code": "Count"
      }, {
        "code": "Distance"
      }, {
        "code": "Duration"
      }, {
        "code": "HumanName"
      }, {
        "code": "Identifier"
      }, {
        "code": "Money"
      }, {
        "code": "Period"
      }, {
        "code": "Quantity"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "Reference"
      }, {
        "code": "SampledData"
      }, {
        "code": "Signature"
      }, {
        "code": "Timing"
      }, {
        "code": "ContactDetail"
      }, {
        "code": "Contributor"
      }, {
        "code": "DataRequirement"
      }, {
        "code": "Expression"
      }, {
        "code": "ParameterDefinition"
      }, {
        "code": "RelatedArtifact"
      }, {
        "code": "TriggerDefinition"
      }, {
        "code": "UsageContext"
      }, {
        "code": "Dosage"
      }, {
        "code": "Meta"
      } ],
      "max": "0",
      "id": "Composition.extension:participant.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "Consent Extension refers to a FHIR Consent instance that indicates a patient's consent",
      "isModifier": false,
      "short": "consent",
      "mapping": [ {
        "map": "authorization.Consent",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "consent",
      "max": "*",
      "label": "consent",
      "id": "Composition.extension:consent",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.extension",
      "min": 0,
      "definition": "The Order Extension represents orders that are fulfilled by this document such as a radiologists report of an x-ray.",
      "isModifier": false,
      "short": "order",
      "mapping": [ {
        "map": "inFulfillmentOf.Order",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/OrderExtension" ]
      } ],
      "mustSupport": true,
      "sliceName": "order",
      "max": "*",
      "label": "order",
      "id": "Composition.extension:order",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.modifierExtension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": true,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "*",
      "id": "Composition.modifierExtension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.modifierExtension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": true,
      "short": "This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status" ]
      } ],
      "mustSupport": true,
      "sliceName": "R5-Composition-status",
      "max": "1",
      "id": "Composition.modifierExtension:R5-Composition-status",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      },
      "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status values such as cancelled (which means that the resource should not be treated as valid)."
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.identifier",
      "min": 0,
      "definition": "A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.",
      "isModifier": false,
      "short": "Version-independent identifier for the Composition",
      "mapping": [ {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": "Document.id / Document.setId",
        "identity": "rim"
      }, {
        "map": ".setId",
        "identity": "cda"
      }, {
        "map": "DocumentReference.masterIdentifier",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.identifier",
      "comment": "Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.status",
      "requirements": "Need to be able to mark interim, amended, or withdrawn compositions or documents.",
      "min": 1,
      "definition": "The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.",
      "isModifier": true,
      "short": "preliminary | final | amended | entered-in-error",
      "mapping": [ {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "FiveWs.status",
        "identity": "w5"
      }, {
        "map": "interim: .completionCode=\"IN\" & ./statusCode[isNormalDatatype()]=\"active\";  final: .completionCode=\"AU\" &&  ./statusCode[isNormalDatatype()]=\"complete\" and not(./inboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()]/source[subsumesCode(\"ActClass#CACT\") and moodCode=\"EVN\" and domainMember(\"ReviseComposition\", code) and isNormalAct()]);  amended: .completionCode=\"AU\" &&  ./statusCode[isNormalDatatype()]=\"complete\" and ./inboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()]/source[subsumesCode(\"ActClass#CACT\") and moodCode=\"EVN\" and domainMember(\"ReviseComposition\", code) and isNormalAct() and statusCode=\"completed\"];  withdrawn : .completionCode=NI &&  ./statusCode[isNormalDatatype()]=\"obsolete\"",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      }, {
        "map": "DocumentReference.status",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/composition-status|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "CompositionStatus"
        } ],
        "description": "The workflow/clinical status of the composition."
      },
      "max": "1",
      "id": "Composition.status",
      "comment": "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.   \n\nSome 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.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.status"
      },
      "isModifierReason": "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",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.type",
      "requirements": "Key metadata element describing the composition, used in searching/filtering.",
      "min": 1,
      "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.",
      "isModifier": false,
      "short": "Kind of composition (LOINC if possible)",
      "mapping": [ {
        "map": "Event.code",
        "identity": "workflow"
      }, {
        "map": "FiveWs.class",
        "identity": "w5"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": ".code",
        "identity": "cda"
      }, {
        "map": "DocumentReference.type",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/doc-typecodes",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentType"
        } ],
        "description": "Type of a composition."
      },
      "max": "1",
      "id": "Composition.type",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.type"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.category",
      "requirements": "Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Categorization of Composition",
      "mapping": [ {
        "map": "Event.subject",
        "identity": "workflow"
      }, {
        "map": "FiveWs.class",
        "identity": "w5"
      }, {
        "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      }, {
        "map": "DocumenttReference.category",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/document-classcodes",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentCategory"
        } ],
        "description": "High-level kind of a clinical document at a macro level."
      },
      "max": "*",
      "id": "Composition.category",
      "comment": "This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.category"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.subject",
      "requirements": "Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.",
      "min": 1,
      "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).",
      "isModifier": false,
      "short": "Who and/or what the composition is about",
      "mapping": [ {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=\"SBJ\"].role[typeCode=\"PAT\"]",
        "identity": "rim"
      }, {
        "map": ".recordTarget",
        "identity": "cda"
      }, {
        "map": "DocumentReference.subject",
        "identity": "fhirdocumentreference"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Group" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.subject",
      "comment": "For clinical documents, this is usually the patient.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.subject"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.encounter",
      "requirements": "Provides context for the composition and supports searching.",
      "min": 0,
      "definition": "Describes the clinical encounter or type of care this documentation is associated with.",
      "isModifier": false,
      "short": "Context of the Composition",
      "mapping": [ {
        "map": "Event.context",
        "identity": "workflow"
      }, {
        "map": "FiveWs.context",
        "identity": "w5"
      }, {
        "map": "unique(highest(./outboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()], priorityNumber)/target[moodCode=\"EVN\" and classCode=(\"ENC\", \"PCPR\") and isNormalAct])",
        "identity": "rim"
      }, {
        "map": ".componentOf.encompassingEncounter",
        "identity": "cda"
      }, {
        "map": "DocumentReference.context.encounter",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
      } ],
      "max": "1",
      "id": "Composition.encounter",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.encounter"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.date",
      "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](bundle-definitions.html#Bundle.timestamp) is the date of packaging.",
      "min": 1,
      "definition": "The composition editing time, when the composition was last logically changed by the author.",
      "isModifier": false,
      "short": "Composition editing time",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": ".effectiveTime[type=\"TS\"]",
        "identity": "rim"
      }, {
        "map": ".effectiveTime",
        "identity": "cda"
      }, {
        "map": "DocumentReference.content.attachment.date, DocumentReference.created",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.date",
      "comment": "The Last Modified Date on the composition may be after the date of the document was attested without being changed.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.date"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.author",
      "requirements": "Identifies who is responsible for the content.",
      "min": 1,
      "definition": "Identifies who is responsible for the information in the composition, not necessarily who typed it in.",
      "isModifier": false,
      "short": "Who and/or what authored the composition",
      "mapping": [ {
        "map": "Event.performer",
        "identity": "workflow"
      }, {
        "map": "FiveWs.author",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]",
        "identity": "rim"
      }, {
        "map": ".author.assignedAuthor",
        "identity": "cda"
      }, {
        "map": "DocumentReference.agent",
        "identity": "fhirdocumentreference"
      }, {
        "map": "assignedAuthor.author",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Composition.author",
      "base": {
        "max": "*",
        "min": 1,
        "path": "Composition.author"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.title",
      "min": 1,
      "definition": "Official human-readable label for the composition.",
      "isModifier": false,
      "short": "Human Readable name/title",
      "mapping": [ {
        "map": "./title",
        "identity": "rim"
      }, {
        "map": ".title",
        "identity": "cda"
      }, {
        "map": "DocumentReference.description, DocumentReference.content.attachment.title",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.title",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.title"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.confidentiality",
      "min": 0,
      "definition": "The code specifying the level of confidentiality of the Composition.",
      "isModifier": false,
      "short": "As defined by affinity domain",
      "mapping": [ {
        "map": ".confidentialityCode",
        "identity": "rim"
      }, {
        "map": ".confidentialityCode",
        "identity": "cda"
      }, {
        "map": "DocumentReference.securityLabel",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentConfidentiality"
        } ],
        "description": "Codes specifying the level of confidentiality of the composition."
      },
      "max": "1",
      "id": "Composition.confidentiality",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.confidentiality"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester",
      "requirements": "Identifies responsibility for the accuracy of the composition content.",
      "min": 0,
      "definition": "A participant who has attested to the accuracy of the composition/document.",
      "isModifier": false,
      "short": "Attests to accuracy of composition",
      "mapping": [ {
        "map": ".participation[typeCode=\"AUTHEN\"].role[classCode=\"ASSIGNED\"]",
        "identity": "rim"
      }, {
        "map": ".authenticator/.legalAuthenticator",
        "identity": "cda"
      }, {
        "map": "DocumentReference.authenticator",
        "identity": "fhirdocumentreference"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Slicing based on the resource type",
        "discriminator": [ {
          "path": "mode",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Composition.attester",
      "comment": "Only list each attester once.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.attester"
      },
      "isSummary": false
    }, {
      "path": "Composition.attester.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.attester.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.attester.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.attester.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.attester.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.attester.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.mode",
      "requirements": "Indicates the level of authority of the attestation.",
      "min": 1,
      "definition": "The type of attestation the authenticator offers.",
      "isModifier": false,
      "short": "personal | professional | legal | official",
      "mapping": [ {
        "map": "unique(./modeCode)",
        "identity": "rim"
      }, {
        "map": "implied by .authenticator/.legalAuthenticator",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "CompositionAttestationMode"
        } ],
        "description": "The way in which a person authenticated a composition."
      },
      "max": "1",
      "id": "Composition.attester.mode",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.attester.mode"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.time",
      "requirements": "Identifies when the information in the composition was deemed accurate.  (Things may have changed since then.).",
      "min": 0,
      "definition": "When the composition was attested by the party.",
      "isModifier": false,
      "short": "When the composition was attested",
      "mapping": [ {
        "map": "./time[type=\"TS\" and isNormalDatatype()]",
        "identity": "rim"
      }, {
        "map": ".authenticator.time",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.attester.time",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.attester.time"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.party",
      "requirements": "Identifies who has taken on the responsibility for accuracy of the composition content.",
      "min": 0,
      "definition": "Who attested the composition in the specified way.",
      "isModifier": false,
      "short": "Who attested the composition",
      "mapping": [ {
        "map": "FiveWs.witness",
        "identity": "w5"
      }, {
        "map": "./role[classCode=\"ASSIGNED\" and isNormalRole]/player[determinerCode=\"INST\" and classCode=(\"DEV\", \"PSN\") and isNormalEntity()] or ./role[classCode=\"ASSIGNED\" and isNormalRole and not(player)]/scoper[determinerCode=\"INST\" and classCode=\"ORG\" and isNormalEntity()]",
        "identity": "rim"
      }, {
        "map": ".authenticator.assignedEnttty",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.attester.party",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.attester.party"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester",
      "requirements": "Identifies responsibility for the accuracy of the composition content.",
      "min": 0,
      "definition": "A participant who has attested to the accuracy of the composition/document.",
      "isModifier": false,
      "short": "aka legal authenticator",
      "mapping": [ {
        "map": ".participation[typeCode=\"AUTHEN\"].role[classCode=\"ASSIGNED\"]",
        "identity": "rim"
      }, {
        "map": ".authenticator/.legalAuthenticator",
        "identity": "cda"
      }, {
        "map": "DocumentReference.authenticator",
        "identity": "fhirdocumentreference"
      }, {
        "map": "assignedEntity.legalAuthenticator",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "legal_attester",
      "max": "1",
      "id": "Composition.attester:legal_attester",
      "comment": "Only list each attester once.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.attester"
      },
      "isSummary": false
    }, {
      "path": "Composition.attester.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.attester:legal_attester.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.attester.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.attester:legal_attester.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.attester.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.attester:legal_attester.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.mode",
      "requirements": "Indicates the level of authority of the attestation.",
      "min": 1,
      "definition": "The type of attestation the authenticator offers.",
      "isModifier": false,
      "short": "personal | professional | legal | official",
      "mapping": [ {
        "map": "unique(./modeCode)",
        "identity": "rim"
      }, {
        "map": "implied by .authenticator/.legalAuthenticator",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "patternCode": "legal",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "CompositionAttestationMode"
        } ],
        "description": "The way in which a person authenticated a composition."
      },
      "max": "1",
      "id": "Composition.attester:legal_attester.mode",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.attester.mode"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.time",
      "requirements": "Identifies when the information in the composition was deemed accurate.  (Things may have changed since then.).",
      "min": 0,
      "definition": "When the composition was attested by the party.",
      "isModifier": false,
      "short": "When the composition was attested",
      "mapping": [ {
        "map": "./time[type=\"TS\" and isNormalDatatype()]",
        "identity": "rim"
      }, {
        "map": ".authenticator.time",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Composition.attester:legal_attester.time",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.attester.time"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.party",
      "requirements": "Identifies who has taken on the responsibility for accuracy of the composition content.",
      "min": 0,
      "definition": "Who attested the composition in the specified way.",
      "isModifier": false,
      "short": "Who attested the composition",
      "mapping": [ {
        "map": "FiveWs.witness",
        "identity": "w5"
      }, {
        "map": "./role[classCode=\"ASSIGNED\" and isNormalRole]/player[determinerCode=\"INST\" and classCode=(\"DEV\", \"PSN\") and isNormalEntity()] or ./role[classCode=\"ASSIGNED\" and isNormalRole and not(player)]/scoper[determinerCode=\"INST\" and classCode=\"ORG\" and isNormalEntity()]",
        "identity": "rim"
      }, {
        "map": ".authenticator.assignedEnttty",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Composition.attester:legal_attester.party",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.attester.party"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester",
      "requirements": "Identifies responsibility for the accuracy of the composition content.",
      "min": 0,
      "definition": "A participant who has attested to the accuracy of the composition/document.",
      "isModifier": false,
      "short": "aka authenticator",
      "mapping": [ {
        "map": ".participation[typeCode=\"AUTHEN\"].role[classCode=\"ASSIGNED\"]",
        "identity": "rim"
      }, {
        "map": ".authenticator/.legalAuthenticator",
        "identity": "cda"
      }, {
        "map": "DocumentReference.authenticator",
        "identity": "fhirdocumentreference"
      }, {
        "map": "assignedEntity.authenticator",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "professional_attester",
      "max": "*",
      "id": "Composition.attester:professional_attester",
      "comment": "Only list each attester once.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.attester"
      },
      "isSummary": false
    }, {
      "path": "Composition.attester.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.attester:professional_attester.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.attester.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.attester:professional_attester.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.attester.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.attester:professional_attester.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.mode",
      "requirements": "Indicates the level of authority of the attestation.",
      "min": 1,
      "definition": "The type of attestation the authenticator offers.",
      "isModifier": false,
      "short": "personal | professional | legal | official",
      "mapping": [ {
        "map": "unique(./modeCode)",
        "identity": "rim"
      }, {
        "map": "implied by .authenticator/.legalAuthenticator",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "patternCode": "professional",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "CompositionAttestationMode"
        } ],
        "description": "The way in which a person authenticated a composition."
      },
      "max": "1",
      "id": "Composition.attester:professional_attester.mode",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.attester.mode"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.time",
      "requirements": "Identifies when the information in the composition was deemed accurate.  (Things may have changed since then.).",
      "min": 0,
      "definition": "When the composition was attested by the party.",
      "isModifier": false,
      "short": "When the composition was attested",
      "mapping": [ {
        "map": "./time[type=\"TS\" and isNormalDatatype()]",
        "identity": "rim"
      }, {
        "map": ".authenticator.time",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Composition.attester:professional_attester.time",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.attester.time"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.attester.party",
      "requirements": "Identifies who has taken on the responsibility for accuracy of the composition content.",
      "min": 0,
      "definition": "Who attested the composition in the specified way.",
      "isModifier": false,
      "short": "Who attested the composition",
      "mapping": [ {
        "map": "FiveWs.witness",
        "identity": "w5"
      }, {
        "map": "./role[classCode=\"ASSIGNED\" and isNormalRole]/player[determinerCode=\"INST\" and classCode=(\"DEV\", \"PSN\") and isNormalEntity()] or ./role[classCode=\"ASSIGNED\" and isNormalRole and not(player)]/scoper[determinerCode=\"INST\" and classCode=\"ORG\" and isNormalEntity()]",
        "identity": "rim"
      }, {
        "map": ".authenticator.assignedEnttty",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Composition.attester:professional_attester.party",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.attester.party"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.custodian",
      "requirements": "Identifies where to go to find the current version, where to report issues, etc.",
      "min": 1,
      "definition": "Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.",
      "isModifier": false,
      "short": "Organization which maintains the composition",
      "mapping": [ {
        "map": ".participation[typeCode=\"RCV\"].role[classCode=\"CUST\"].scoper[classCode=\"ORG\" and determinerCode=\"INST\"]",
        "identity": "rim"
      }, {
        "map": ".custodian.assignedCustodian",
        "identity": "cda"
      }, {
        "map": "DocumentReference.custodian",
        "identity": "fhirdocumentreference"
      }, {
        "map": "assignedCustodian.custodian",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.custodian",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.custodian"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo",
      "min": 0,
      "definition": "Relationships that this composition has with other compositions or documents that already exist.",
      "isModifier": false,
      "short": "Relationships to other compositions/documents",
      "mapping": [ {
        "map": ".outboundRelationship",
        "identity": "rim"
      }, {
        "map": ".relatedDocument",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo",
        "identity": "fhirdocumentreference"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Slicing based on code",
        "discriminator": [ {
          "path": "code",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Composition.relatesTo",
      "comment": "A document is a version specific composition.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.relatesTo"
      },
      "isSummary": false
    }, {
      "path": "Composition.relatesTo.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.relatesTo.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.relatesTo.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.relatesTo.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.code",
      "min": 1,
      "definition": "The type of relationship that this composition has with anther composition or document.",
      "isModifier": false,
      "short": "replaces | transforms | signs | appends",
      "mapping": [ {
        "map": ".outboundRelationship.typeCode",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.typeCode",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.code",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentRelationshipType"
        } ],
        "description": "The type of relationship between documents."
      },
      "max": "1",
      "id": "Composition.relatesTo.code",
      "comment": "If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.code"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x]",
      "min": 1,
      "definition": "The target composition/document of this relationship.",
      "isModifier": false,
      "short": "Target of the relationship",
      "mapping": [ {
        "map": ".target[classCode=\"DOC\", moodCode=\"EVN\"].id",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.id",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.target",
        "identity": "fhirdocumentreference"
      } ],
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      },
      "type": [ {
        "code": "Identifier"
      }, {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Composition" ]
      } ],
      "max": "1",
      "id": "Composition.relatesTo.target[x]",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.target[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x]",
      "min": 0,
      "definition": "The target composition/document of this relationship.",
      "isModifier": false,
      "short": "Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document",
      "mapping": [ {
        "map": ".target[classCode=\"DOC\", moodCode=\"EVN\"].id",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.id",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.target",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "sliceName": "targetIdentifier",
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.target[x]"
      },
      "isSummary": false
    }, {
      "path": "Composition.relatesTo.target[x].id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.target[x].extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x].use",
      "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
      "min": 0,
      "definition": "The purpose of this identifier.",
      "isModifier": true,
      "short": "usual | official | temp | secondary | old (If known)",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "Role.code or implied by context",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "IdentifierUse"
        } ],
        "description": "Identifies the purpose for this identifier, if known ."
      },
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.use",
      "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.use"
      },
      "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x].type",
      "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
      "min": 0,
      "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
      "isModifier": false,
      "short": "Description of identifier",
      "mapping": [ {
        "map": "CX.5",
        "identity": "v2"
      }, {
        "map": "Role.code or implied by context",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "IdentifierType"
        } ],
        "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
      },
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.type",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.type"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x].system",
      "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.",
      "min": 1,
      "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
      "isModifier": false,
      "short": "The namespace for the identifier value",
      "mapping": [ {
        "map": "CX.4 / EI-2-4",
        "identity": "v2"
      }, {
        "map": "II.root or Role.id.root",
        "identity": "rim"
      }, {
        "map": "./IdentifierType",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.system",
      "comment": "Identifier.system is always case sensitive.",
      "example": [ {
        "label": "General",
        "valueUri": "http://www.acme.com/identifiers/patient"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.system"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x].value",
      "min": 1,
      "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
      "isModifier": false,
      "short": "The value that is unique",
      "mapping": [ {
        "map": "CX.1 / EI.1",
        "identity": "v2"
      }, {
        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)",
        "identity": "rim"
      }, {
        "map": "./Value",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.value",
      "comment": "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](http://hl7.org/fhir/R4/extension-rendered-value.html). 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.",
      "example": [ {
        "label": "General",
        "valueString": "123456"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.value"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x].period",
      "min": 0,
      "definition": "Time period during which identifier is/was valid for use.",
      "isModifier": false,
      "short": "Time period when id is/was valid for use",
      "mapping": [ {
        "map": "CX.7 + CX.8",
        "identity": "v2"
      }, {
        "map": "Role.effectiveTime or implied by context",
        "identity": "rim"
      }, {
        "map": "./StartDate and ./EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.period",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x].assigner",
      "min": 0,
      "definition": "Organization that issued/manages the identifier.",
      "isModifier": false,
      "short": "Organization that issued id (may be just text)",
      "mapping": [ {
        "map": "CX.4 / (CX.4,CX.9,CX.10)",
        "identity": "v2"
      }, {
        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper",
        "identity": "rim"
      }, {
        "map": "./IdentifierIssuingAuthority",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Composition.relatesTo.target[x]:targetIdentifier.assigner",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.assigner"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo",
      "min": 0,
      "definition": "Relationships that this composition has with other compositions or documents that already exist.",
      "isModifier": false,
      "short": "The document(s) being superceded",
      "mapping": [ {
        "map": ".outboundRelationship",
        "identity": "rim"
      }, {
        "map": ".relatedDocument",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo",
        "identity": "fhirdocumentreference"
      }, {
        "map": "parentDocument.relatedDocument",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "replaced_document",
      "max": "*",
      "id": "Composition.relatesTo:replaced_document",
      "comment": "A document is a version specific composition.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.relatesTo"
      },
      "isSummary": false
    }, {
      "path": "Composition.relatesTo.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.relatesTo:replaced_document.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.relatesTo:replaced_document.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.relatesTo:replaced_document.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.code",
      "min": 1,
      "definition": "The type of relationship that this composition has with anther composition or document.",
      "isModifier": false,
      "short": "replaces | transforms | signs | appends",
      "mapping": [ {
        "map": ".outboundRelationship.typeCode",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.typeCode",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.code",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "patternCode": "replaces",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentRelationshipType"
        } ],
        "description": "The type of relationship between documents."
      },
      "max": "1",
      "id": "Composition.relatesTo:replaced_document.code",
      "comment": "If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.code"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x]",
      "min": 1,
      "definition": "The target composition/document of this relationship.",
      "isModifier": false,
      "short": "Target of the relationship",
      "mapping": [ {
        "map": ".target[classCode=\"DOC\", moodCode=\"EVN\"].id",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.id",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.target",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "sliceName": "targetIdentifier",
      "max": "1",
      "id": "Composition.relatesTo:replaced_document.target[x]:targetIdentifier",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.target[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo",
      "min": 0,
      "definition": "Relationships that this composition has with other compositions or documents that already exist.",
      "isModifier": false,
      "short": "The document(s) being appended too",
      "mapping": [ {
        "map": ".outboundRelationship",
        "identity": "rim"
      }, {
        "map": ".relatedDocument",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "appended_document",
      "max": "*",
      "id": "Composition.relatesTo:appended_document",
      "comment": "A document is a version specific composition.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.relatesTo"
      },
      "isSummary": false
    }, {
      "path": "Composition.relatesTo.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.relatesTo:appended_document.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.relatesTo:appended_document.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.relatesTo.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.relatesTo:appended_document.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.code",
      "min": 1,
      "definition": "The type of relationship that this composition has with anther composition or document.",
      "isModifier": false,
      "short": "replaces | transforms | signs | appends",
      "mapping": [ {
        "map": ".outboundRelationship.typeCode",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.typeCode",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.code",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "patternCode": "appends",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentRelationshipType"
        } ],
        "description": "The type of relationship between documents."
      },
      "max": "1",
      "id": "Composition.relatesTo:appended_document.code",
      "comment": "If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.code"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.relatesTo.target[x]",
      "min": 1,
      "definition": "The target composition/document of this relationship.",
      "isModifier": false,
      "short": "Target of the relationship",
      "mapping": [ {
        "map": ".target[classCode=\"DOC\", moodCode=\"EVN\"].id",
        "identity": "rim"
      }, {
        "map": ".relatedDocument.id",
        "identity": "cda"
      }, {
        "map": "DocumentReference.relatesTo.target",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "sliceName": "targetIdentifier",
      "max": "1",
      "id": "Composition.relatesTo:appended_document.target[x]:targetIdentifier",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Composition.relatesTo.target[x]"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.event",
      "requirements": "Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.",
      "min": 0,
      "definition": "The clinical service, such as a colonoscopy or an appendectomy, being documented.",
      "isModifier": false,
      "short": "The clinical service(s) being documented",
      "mapping": [ {
        "map": "outboundRelationship[typeCode=\"SUBJ\"].target[classCode<'ACT']",
        "identity": "rim"
      }, {
        "map": ".documentationOf.serviceEvent",
        "identity": "cda"
      }, {
        "map": "DocumentReference.event",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Composition.event",
      "comment": "The event needs to be consistent with the type element, though can provide further information if desired.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.event"
      },
      "isSummary": true
    }, {
      "path": "Composition.event.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.event.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.event.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.event.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.event.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.event.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.event.code",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Code(s) that apply to the event being documented",
      "mapping": [ {
        "map": ".code",
        "identity": "rim"
      }, {
        "map": ".code",
        "identity": "cda"
      }, {
        "map": "DocumentReference.event.code",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://terminology.hl7.org/ValueSet/v3-ActCode",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DocumentEventType"
        } ],
        "description": "This list of codes represents the main clinical acts being documented."
      },
      "max": "*",
      "id": "Composition.event.code",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.event.code"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.event.period",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "The period covered by the documentation",
      "mapping": [ {
        "map": ".effectiveTime",
        "identity": "rim"
      }, {
        "map": ".effectiveTime",
        "identity": "cda"
      }, {
        "map": "DocumentReference.event.period",
        "identity": "fhirdocumentreference"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Composition.event.period",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.event.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.event.detail",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "The event(s) being documented",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=\"SUBJ\"].target",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
      } ],
      "max": "*",
      "id": "Composition.event.detail",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.event.detail"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "cmp-1",
        "human": "A section must contain at least one of text, entries, or sub-sections",
        "xpath": "exists(f:text) or exists(f:entry) or exists(f:section)",
        "source": "http://hl7.org/fhir/StructureDefinition/Composition",
        "severity": "error",
        "expression": "text.exists() or entry.exists() or section.exists()"
      }, {
        "key": "cmp-2",
        "human": "A section can only have an emptyReason if it is empty",
        "xpath": "not(exists(f:emptyReason) and exists(f:entry))",
        "source": "http://hl7.org/fhir/StructureDefinition/Composition",
        "severity": "error",
        "expression": "emptyReason.empty() or entry.empty()"
      }, {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section",
      "min": 1,
      "definition": "The root of the sections that make up the composition.",
      "isModifier": false,
      "short": "Composition is broken into sections",
      "mapping": [ {
        "map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
        "identity": "rim"
      }, {
        "map": ".component.structuredBody.component.section",
        "identity": "cda"
      }, {
        "map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
        "identity": "cda"
      }, {
        "map": "bodyChoice.component.NonXMLBody",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Composition.section",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.section"
      },
      "isSummary": false
    }, {
      "path": "Composition.section.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Composition.section.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.section.extension",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Composition.section.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Composition.section.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Composition.section.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.title",
      "requirements": "Section headings are often standardized for different types of documents.  They give guidance to humans on how the document is organized.",
      "min": 1,
      "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.",
      "isModifier": false,
      "short": "Label for section (e.g. for ToC)",
      "mapping": [ {
        "map": "./title",
        "identity": "rim"
      }, {
        "map": ".title",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "alias": [ "header", "label", "caption" ],
      "max": "1",
      "id": "Composition.section.title",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.title"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.code",
      "requirements": "Provides computable standardized labels to topics within the document.",
      "min": 0,
      "definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
      "isModifier": false,
      "short": "Classification of section (recommended)",
      "mapping": [ {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": ".code",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "CompositionSectionType"
        } ],
        "description": "Classification of a section of a composition/document."
      },
      "max": "1",
      "id": "Composition.section.code",
      "comment": "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.   \n\nIf 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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.code"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.author",
      "requirements": "Identifies who is responsible for the content.",
      "min": 0,
      "definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
      "isModifier": false,
      "short": "Who and/or what authored the section",
      "mapping": [ {
        "map": "FiveWs.author",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]",
        "identity": "rim"
      }, {
        "map": ".author.assignedAuthor",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "*",
      "id": "Composition.section.author",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.section.author"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.focus",
      "min": 0,
      "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).",
      "isModifier": false,
      "short": "Who/what the section is about, when it is not about the subject of composition",
      "mapping": [ {
        "map": ".subject? (CDA did not differentiate between subject and focus)",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
      } ],
      "max": "1",
      "id": "Composition.section.focus",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.focus"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.text",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Text summary of the section, for human interpretation",
      "mapping": [ {
        "map": ".text",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Composition.section.text",
      "condition": [ "cmp-1" ],
      "comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.text"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.mode",
      "requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "working | snapshot | changes",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      }, {
        "map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SectionMode"
        } ],
        "description": "The processing mode that applies to this section."
      },
      "max": "1",
      "id": "Composition.section.mode",
      "comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.mode"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.orderedBy",
      "requirements": "Important for presentation and rendering.  Lists may be sorted to place more important information first or to group related entries.",
      "min": 0,
      "definition": "Specifies the order applied to the items in the section entries.",
      "isModifier": false,
      "short": "Order of section entries",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/list-order",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SectionEntryOrder"
        } ],
        "description": "What order applies to the items in the entry."
      },
      "max": "1",
      "id": "Composition.section.orderedBy",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.orderedBy"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.entry",
      "min": 0,
      "definition": "A reference to the actual resource from which the narrative in the section is derived.",
      "isModifier": false,
      "short": "A reference to data that supports this section",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP] or  .participation[typeCode=SBJ]",
        "identity": "rim"
      }, {
        "map": ".entry",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
      } ],
      "max": "*",
      "id": "Composition.section.entry",
      "condition": [ "cmp-2" ],
      "comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.section.entry"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.emptyReason",
      "requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
      "min": 0,
      "definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
      "isModifier": false,
      "short": "Why the section is empty",
      "mapping": [ {
        "map": ".inboundRelationship[typeCode=SUBJ,code,
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SectionEmptyReason"
        } ],
        "description": "If a section is empty, why it is empty."
      },
      "max": "1",
      "id": "Composition.section.emptyReason",
      "condition": [ "cmp-2" ],
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Composition.section.emptyReason"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Composition.section.section",
      "min": 0,
      "definition": "A nested sub-section within this section.",
      "isModifier": false,
      "short": "Nested Section",
      "mapping": [ {
        "map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
        "identity": "rim"
      }, {
        "map": ".component.section",
        "identity": "cda"
      } ],
      "contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
      "max": "*",
      "id": "Composition.section.section",
      "condition": [ "cmp-1" ],
      "comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Composition.section.section"
      },
      "isSummary": false
    } ]
  },
  "status": "draft",
  "id": "3b95657e-ba36-4afb-944c-f16450bde5d5",
  "kind": "resource",
  "url": "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/clinical-document-composition",
  "version": "1.0.0-ballot",
  "differential": {
    "element": [ {
      "id": "Composition",
      "path": "Composition",
      "constraint": [ {
        "key": "clindoc-limit-participantType",
        "human": "FHIR Clinical Document Composition Profile contains fields for AUT, AUTHEN, CST, LA, RCT, SBJ. These types are not allowed as types in the Participant Extension",
        "source": "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/clinical-document-composition",
        "severity": "error",
        "expression": "extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='AUT').not() and extension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='AUTHEN').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='CST').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='LA').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='RCT').not() and\nextension.where(url='http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension').extension.where(url='type').value.coding.exists(system='http://terminology.hl7.org/CodeSystem/v3-ParticipationType' and code='SBJ').not()"
      } ]
    }, {
      "id": "Composition.language",
      "path": "Composition.language",
      "mapping": [ {
        "map": "languageCode",
        "identity": "cda"
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.text",
      "path": "Composition.text",
      "mustSupport": true
    }, {
      "id": "Composition.extension",
      "path": "Composition.extension",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "path": "Composition.extension",
      "min": 0,
      "mapping": [ {
        "map": "versionNumber",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version" ]
      } ],
      "mustSupport": true,
      "sliceName": "R5-Composition-version",
      "max": "1",
      "label": "clinical document version number",
      "id": "Composition.extension:R5-Composition-version"
    }, {
      "path": "Composition.extension",
      "min": 0,
      "short": "A Data Enterer represents the person who transferred the content, written or dictated, into the clinical document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author's information to the electronic system.",
      "mapping": [ {
        "map": "assignedEntity.dataEnterer",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/data-enterer-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "data-enterer",
      "max": "1",
      "label": "date enterer",
      "id": "Composition.extension:data-enterer"
    }, {
      "path": "Composition.extension",
      "min": 0,
      "short": "An Informant is an information source for any content within the clinical document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.",
      "mapping": [ {
        "map": "informantChoice.informant",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/informant-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "informant",
      "max": "*",
      "label": "informant",
      "id": "Composition.extension:informant"
    }, {
      "path": "Composition.extension",
      "min": 0,
      "short": "An Information Recipient is the intended recipient of the information at the time the document was created.",
      "mapping": [ {
        "map": "intendedRecipient.informationRecipient",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/information-recipient-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "information-recipient",
      "max": "*",
      "label": "information recipient of type primary, secondary information recipient or a generic information recipient",
      "id": "Composition.extension:information-recipient"
    }, {
      "path": "Composition.extension",
      "min": 0,
      "short": "A Participant that is not a data-enter, information-recipient nor an informant",
      "mapping": [ {
        "map": "associatedEntity.participant",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ParticipantExtension" ]
      } ],
      "mustSupport": true,
      "sliceName": "participant",
      "max": "*",
      "label": "A Participant that is not a data-enter, information-recipient nor an informant",
      "id": "Composition.extension:participant"
    }, {
      "id": "Composition.extension:participant.extension:type",
      "path": "Composition.extension.extension",
      "sliceName": "type"
    }, {
      "id": "Composition.extension:participant.extension:type.value[x]",
      "path": "Composition.extension.extension.value[x]",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/fhir-clinical-document/ValueSet/clinical-doc-participant-vs",
        "description": "particpants that are not a data-enter, information-recipient nor an informant"
      }
    }, {
      "path": "Composition.extension",
      "min": 0,
      "short": "consent",
      "mapping": [ {
        "map": "authorization.Consent",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/consent-extension" ]
      } ],
      "mustSupport": true,
      "sliceName": "consent",
      "max": "*",
      "label": "consent",
      "id": "Composition.extension:consent"
    }, {
      "path": "Composition.extension",
      "min": 0,
      "short": "order",
      "mapping": [ {
        "map": "inFulfillmentOf.Order",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/OrderExtension" ]
      } ],
      "mustSupport": true,
      "sliceName": "order",
      "max": "*",
      "label": "order",
      "id": "Composition.extension:order"
    }, {
      "id": "Composition.modifierExtension",
      "path": "Composition.modifierExtension",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "path": "Composition.modifierExtension",
      "min": 0,
      "short": "This allows for additional status values found in R5. However, exercise caution as the R4 Composition.status is required.",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.status" ]
      } ],
      "mustSupport": true,
      "sliceName": "R5-Composition-status",
      "max": "1",
      "id": "Composition.modifierExtension:R5-Composition-status",
      "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status values such as cancelled (which means that the resource should not be treated as valid)."
    }, {
      "id": "Composition.identifier",
      "path": "Composition.identifier",
      "mustSupport": true
    }, {
      "id": "Composition.type",
      "path": "Composition.type",
      "mustSupport": true
    }, {
      "id": "Composition.subject",
      "min": 1,
      "path": "Composition.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Group" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.date",
      "path": "Composition.date",
      "mustSupport": true
    }, {
      "id": "Composition.author",
      "path": "Composition.author",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "mapping": [ {
        "map": "assignedAuthor.author",
        "identity": "cda"
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.title",
      "path": "Composition.title",
      "mustSupport": true
    }, {
      "id": "Composition.attester",
      "path": "Composition.attester",
      "slicing": {
        "rules": "open",
        "description": "Slicing based on the resource type",
        "discriminator": [ {
          "path": "mode",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Composition.attester.mode",
      "path": "Composition.attester.mode",
      "mustSupport": true
    }, {
      "id": "Composition.attester.time",
      "path": "Composition.attester.time",
      "mustSupport": true
    }, {
      "id": "Composition.attester.party",
      "path": "Composition.attester.party",
      "mustSupport": true
    }, {
      "id": "Composition.attester:legal_attester",
      "max": "1",
      "min": 0,
      "path": "Composition.attester",
      "short": "aka legal authenticator",
      "mapping": [ {
        "map": "assignedEntity.legalAuthenticator",
        "identity": "cda"
      } ],
      "sliceName": "legal_attester",
      "mustSupport": true
    }, {
      "id": "Composition.attester:legal_attester.mode",
      "path": "Composition.attester.mode",
      "patternCode": "legal"
    }, {
      "id": "Composition.attester:professional_attester",
      "max": "*",
      "min": 0,
      "path": "Composition.attester",
      "short": "aka authenticator",
      "mapping": [ {
        "map": "assignedEntity.authenticator",
        "identity": "cda"
      } ],
      "sliceName": "professional_attester",
      "mustSupport": true
    }, {
      "id": "Composition.attester:professional_attester.mode",
      "path": "Composition.attester.mode",
      "patternCode": "professional"
    }, {
      "id": "Composition.custodian",
      "min": 1,
      "path": "Composition.custodian",
      "mapping": [ {
        "map": "assignedCustodian.custodian",
        "identity": "cda"
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.relatesTo",
      "path": "Composition.relatesTo",
      "slicing": {
        "rules": "open",
        "description": "Slicing based on code",
        "discriminator": [ {
          "path": "code",
          "type": "value"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Composition.relatesTo.target[x]",
      "path": "Composition.relatesTo.target[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "Composition.relatesTo.target[x]:targetIdentifier",
      "max": "1",
      "min": 0,
      "path": "Composition.relatesTo.target[x]",
      "type": [ {
        "code": "Identifier"
      } ],
      "short": "Reference to the Bundle.identifier of the FHIR Clinical Document being appended, or to some other identifier of a non FHIR document",
      "sliceName": "targetIdentifier"
    }, {
      "id": "Composition.relatesTo.target[x]:targetIdentifier.system",
      "min": 1,
      "path": "Composition.relatesTo.target[x].system"
    }, {
      "id": "Composition.relatesTo.target[x]:targetIdentifier.value",
      "min": 1,
      "path": "Composition.relatesTo.target[x].value"
    }, {
      "id": "Composition.relatesTo:replaced_document",
      "max": "*",
      "min": 0,
      "path": "Composition.relatesTo",
      "short": "The document(s) being superceded",
      "mapping": [ {
        "map": "parentDocument.relatedDocument",
        "identity": "cda"
      } ],
      "sliceName": "replaced_document",
      "mustSupport": true
    }, {
      "id": "Composition.relatesTo:replaced_document.code",
      "path": "Composition.relatesTo.code",
      "patternCode": "replaces"
    }, {
      "id": "Composition.relatesTo:replaced_document.target[x]:targetIdentifier",
      "min": 1,
      "path": "Composition.relatesTo.target[x]",
      "type": [ {
        "code": "Identifier"
      } ],
      "sliceName": "targetIdentifier"
    }, {
      "id": "Composition.relatesTo:appended_document",
      "max": "*",
      "min": 0,
      "path": "Composition.relatesTo",
      "short": "The document(s) being appended too",
      "sliceName": "appended_document",
      "mustSupport": true
    }, {
      "id": "Composition.relatesTo:appended_document.code",
      "path": "Composition.relatesTo.code",
      "patternCode": "appends"
    }, {
      "id": "Composition.relatesTo:appended_document.target[x]:targetIdentifier",
      "min": 1,
      "path": "Composition.relatesTo.target[x]",
      "type": [ {
        "code": "Identifier"
      } ],
      "sliceName": "targetIdentifier"
    }, {
      "id": "Composition.section",
      "min": 1,
      "path": "Composition.section",
      "mapping": [ {
        "map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
        "identity": "cda"
      }, {
        "map": "bodyChoice.component.NonXMLBody",
        "identity": "cda"
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section.title",
      "min": 1,
      "path": "Composition.section.title",
      "mustSupport": true
    }, {
      "id": "Composition.section.code",
      "path": "Composition.section.code",
      "mustSupport": true
    }, {
      "id": "Composition.section.text",
      "path": "Composition.section.text",
      "mustSupport": true
    } ]
  },
  "contact": [ {
    "name": "HL7 International / Structured Documents",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/structure",
      "system": "url"
    }, {
      "value": "strucdoc@lists.hl7.org",
      "system": "email"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Composition"
}