{
"description": "This profile defines obligations for a Hospital Discharge Report (HDR) for the scope of this guide.",
"_filename": "StructureDefinition-composition-obl-eu-hdr.json",
"package_name": "hl7.fhir.eu.hdr",
"date": "2026-10-16T15:31:00+02:00",
"derivation": "constraint",
"publisher": "HL7 Europe",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "150",
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"display": "Europe"
} ]
} ],
"name": "CompositionEuHdrObligation",
"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": "Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0).",
"type": "Composition",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "Composition: obligations",
"package_version": "1.0.0",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 0
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "informative"
} ],
"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": "cmp-hdr-2",
"human": "At least one of the Discharge summary (LOINC 18842-5) or Hospital course (LOINC 8648-8) sections SHALL be present. Both may be present.",
"source": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-eu-hdr",
"severity": "error",
"expression": "section.where(code.coding.where(system = 'http://loinc.org' and code = '18842-5').exists()).exists() or section.where(code.coding.where(system = 'http://loinc.org' and code = '8648-8').exists()).exists()"
} ],
"path": "Composition",
"min": 0,
"definition": "Hospital Discharge Report composition. \r\nA composition is a set of healthcare-related information that is assembled together into a single logical document 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. \r\nWhile a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.",
"isModifier": false,
"short": "Hospital Discharge Report composition",
"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",
"type": [ {
"code": "code"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1",
"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"
} ],
"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": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
"isModifier": false,
"short": "Fulfills plan, proposal or order",
"mapping": [ {
"map": "Event.basedOn",
"identity": "workflow"
}, {
"map": "ORC in proximity to EVN segment",
"identity": "v2"
}, {
"map": ".outboundRelationship[typeCode=FLFS].target",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/event-basedOn" ]
} ],
"sliceName": "basedOn",
"max": "*",
"id": "Composition.extension:basedOn",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"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:basedOn.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": 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:basedOn.extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"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/StructureDefinition/event-basedOn",
"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:basedOn.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": 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/Resource", "http://hl7.org/fhir/StructureDefinition/ServiceRequest" ]
} ],
"max": "1",
"id": "Composition.extension:basedOn.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|4.0.1",
"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|4.0.1",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Composition.extension",
"min": 0,
"definition": "R5: `Composition.version` (new:string)",
"isModifier": false,
"short": "Business version",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version" ]
} ],
"sliceName": "version",
"max": "1",
"id": "Composition.extension:version",
"condition": [ "ele-1" ],
"comment": "Element `Composition.version` has a context of Composition based on following the parent source element upwards and mapping to `Composition`.\nElement `Composition.version` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nWhile each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the Composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.",
"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": "This extension applies to the Composition resource and is used to represent an intended recipient of the composition.",
"isModifier": false,
"short": "Composition: Information recipient",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.eu/fhir/StructureDefinition/information-recipient" ]
} ],
"sliceName": "informationRecipient",
"max": "*",
"id": "Composition.extension:informationRecipient",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"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:informationRecipient.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": 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:informationRecipient.extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"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.eu/fhir/StructureDefinition/information-recipient",
"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:informationRecipient.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": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/practitionerRole-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/practitioner-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/device-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/patient-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/relatedPerson-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/organization-obl-eu-hdr" ]
} ],
"max": "1",
"id": "Composition.extension:informationRecipient.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.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 resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\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",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Composition.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": "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())"
} ],
"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": "HDR business identifier",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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": "HDR status",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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 that this composition refer to a Hospital Discharge Report",
"isModifier": false,
"short": "Kind of composition (\"Hospital Discharge Report\")",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1",
"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.",
"patternCodeableConcept": {
"coding": [ {
"code": "34105-7",
"system": "http://loinc.org"
} ]
},
"base": {
"max": "1",
"min": 1,
"path": "Composition.type"
},
"isSummary": true
}, {
"path": "Composition.type.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.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.type.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.type.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.type.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"max": "*",
"id": "Composition.type.coding",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "Composition.type.coding.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.type.coding.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.type.coding.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.type.coding.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.type.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "Composition.type.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.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.type.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "Composition.type.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"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.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"max": "1",
"id": "Composition.type.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.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.type.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 1,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "Composition.type.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"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.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "Composition.type.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"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.text",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "Composition.type.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1",
"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)).",
"example": [ {
"label": "Document category",
"valueCoding": {
"code": "LP72467-1",
"system": "http://loinc.org",
"display": "Discharge summary note"
}
} ],
"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. \r\nIn general a 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).\r\nFor the hdr the subject is always the patient.",
"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.eu/fhir/hdr/StructureDefinition/patient-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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": 1,
"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.eu/fhir/hdr/StructureDefinition/encounter-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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](http://hl7.org/fhir/R4/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": "HDR date",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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 Hospital Discharge Report, not necessarily who typed it in.",
"isModifier": false,
"short": "Who and/or what authored the Hospital Discharge Report",
"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"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/practitioner-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/practitionerRole-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/device-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/organization-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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.\r\n\r\nFor this document should be \"Hospital Discharge Report\" or any equivalent translation",
"isModifier": false,
"short": "Hospital Discharge Report",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
}, {
"map": "DocumentReference.description, DocumentReference.content.attachment.title",
"identity": "fhirdocumentreference"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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": "The type of attestation",
"mapping": [ {
"map": "unique(./modeCode)",
"identity": "rim"
}, {
"map": "implied by .authenticator/.legalAuthenticator",
"identity": "cda"
} ],
"type": [ {
"code": "code"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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.eu/fhir/hdr/StructureDefinition/practitioner-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/practitionerRole-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/organization-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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.custodian",
"requirements": "Identifies where to go to find the current version, where to report issues, etc.",
"min": 0,
"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"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"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"
} ],
"type": [ {
"code": "Identifier"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Composition|4.0.1" ]
} ],
"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.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",
"requirements": "EHDSDischargeReport.header.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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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|4.0.1" ]
} ],
"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())"
}, {
"key": "cmp-hdr-1",
"human": "A section SHALL have text, sub-sections, or both.",
"source": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-eu-hdr",
"severity": "error",
"expression": "text.exists() or section.exists()"
} ],
"path": "Composition.section",
"min": 1,
"definition": "The root of the sections that make up the HDR composition.",
"isModifier": false,
"short": "Sections composing the HDR",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "code",
"type": "value"
} ]
},
"type": [ {
"code": "BackboneElement"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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"
} ],
"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": 1,
"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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"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|4.0.1" ]
} ],
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"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|4.0.1",
"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|4.0.1" ]
} ],
"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|4.0.1",
"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
}, {
"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": 0,
"definition": "Information about substantial alerts or warnings that health professionals should be aware of. It may also contain allergies and intolerances, which are also documented in the Allergies and intolerances section but flagged here in addition. Alerts cover any clinical information that is imperative to know so that the life or health of the patient does not come under threat, for example a rare disease requiring special treatment, a difficult airway or intubation, malignant hyperthermia, porphyria, bleeding disorders, treatment with anticoagulants or immunosuppressants, transplanted organs, or participation in a clinical trial. Alerts may be coded where a suitable code exists, but given their dynamic nature they are frequently recorded as free text.",
"isModifier": false,
"short": "Substantial alerts and warnings",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionAlert",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionAlert",
"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:sectionAlert.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionAlert.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionAlert.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionAlert.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": 0,
"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 of section, e.g. \"Alerts\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionAlert.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionAlert.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "104605-1",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionAlert.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionAlert.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",
"requirements": "EHDSDischargeReport.body.alerts.generatedNarrative",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionAlert.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:sectionAlert.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|4.0.1",
"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:sectionAlert.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": "Resources describing the alerts and warnings reported in this section.",
"isModifier": false,
"short": "Alerts entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/flag-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionAlert.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.entry",
"min": 0,
"definition": "Contains alert information to be communicated. May optionally reference other resources in the HDR.",
"isModifier": false,
"short": "Alert information",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/flag-obl-eu-hdr" ]
} ],
"sliceName": "flag",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionAlert.entry:flag",
"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|4.0.1",
"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:sectionAlert.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:sectionAlert.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
}, {
"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": 0,
"definition": "Evaluation of the patient at hospital admission, comprising objective findings such as anthropometric observations, vital signs and physical examination, and where relevant the functional status at admission. The admission evaluation is reported only exceptionally, when it is relevant to ensure continuity of care after discharge.",
"isModifier": false,
"short": "Patient evaluation at hospital admission",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionAdmissionEvaluation",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionAdmissionEvaluation",
"comment": "Admission evaluation should be reported only exceptionally, if it is relevant to ensure continuity of care.",
"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:sectionAdmissionEvaluation.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionAdmissionEvaluation.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to this resource or element.",
"isModifier": false,
"short": "Additional notes that apply to this resource or element.",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionAdmissionEvaluation.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionAdmissionEvaluation.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": 0,
"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 of section, e.g. \"Hospital admission evaluation\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionAdmissionEvaluation.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionAdmissionEvaluation.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "67851-6",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionAdmissionEvaluation.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionAdmissionEvaluation.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",
"requirements": "EHDSDischargeReport.body.admissionEvaluation.generatedNarrative",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionAdmissionEvaluation.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:sectionAdmissionEvaluation.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|4.0.1",
"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:sectionAdmissionEvaluation.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|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionAdmissionEvaluation.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|4.0.1",
"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:sectionAdmissionEvaluation.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:sectionAdmissionEvaluation.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
}, {
"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": 0,
"definition": "Vital signs observed during the encounter and at or before discharge, comprising systolic and diastolic blood pressure including the site of measurement, pulse rate and respiratory rate, and optionally oxygen saturation, body temperature and pain score. Notable values such as the most recent, the maximum or minimum, the baseline, or a relevant trend may be reported. Anthropometric observations such as body weight, height, body mass index and circumferences are reported in the Physical findings section.",
"isModifier": false,
"short": "Vital signs during the encounter and at discharge",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionVitalSigns",
"max": "1",
"id": "Composition.section:sectionVitalSigns",
"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:sectionVitalSigns.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionVitalSigns.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionVitalSigns.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionVitalSigns.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": 0,
"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 of section, e.g. \"Vital signs\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionVitalSigns.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionVitalSigns.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "8716-3",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionVitalSigns.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionVitalSigns.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"
} ],
"max": "1",
"id": "Composition.section:sectionVitalSigns.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:sectionVitalSigns.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|4.0.1",
"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:sectionVitalSigns.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.eu/fhir/hdr/StructureDefinition/observation-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference", "http://hl7.org/fhir/StructureDefinition/vitalsigns" ]
} ],
"max": "*",
"id": "Composition.section:sectionVitalSigns.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|4.0.1",
"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:sectionVitalSigns.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:sectionVitalSigns.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
}, {
"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": 0,
"definition": "Objective findings established by examining the patient, comprising the physical examination performed through observation, palpation, percussion and auscultation, and anthropometric observations such as body weight, height, body mass index and the circumference of head, waist, hip and limbs. The narrative should be structured by organ system, for example head, neck, thorax, abdomen and limbs.",
"isModifier": false,
"short": "Objective findings from physical examination",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionPhysicalFindings",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionPhysicalFindings",
"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:sectionPhysicalFindings.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionPhysicalFindings.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionPhysicalFindings.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionPhysicalFindings.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": 0,
"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 of section, e.g. \"Physical findings\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionPhysicalFindings.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionPhysicalFindings.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "29545-1",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionPhysicalFindings.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionPhysicalFindings.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"
} ],
"max": "1",
"id": "Composition.section:sectionPhysicalFindings.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:sectionPhysicalFindings.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|4.0.1",
"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:sectionPhysicalFindings.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.eu/fhir/hdr/StructureDefinition/observation-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionPhysicalFindings.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|4.0.1",
"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:sectionPhysicalFindings.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:sectionPhysicalFindings.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
}, {
"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": 0,
"definition": "The ability of the patient to perform normal daily activities required to meet basic needs, fulfil usual roles and maintain health and well-being. This covers basic activities of daily living such as bathing, feeding and toileting, instrumental activities of daily living such as cooking, shopping and managing one's own affairs, and any need for the patient to be continuously assessed by third parties. Functional status may influence decisions about how to plan and administer treatments.",
"isModifier": false,
"short": "Ability to perform activities of daily living",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionFunctionalStatus",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionFunctionalStatus",
"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:sectionFunctionalStatus.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionFunctionalStatus.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionFunctionalStatus.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionFunctionalStatus.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": 0,
"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 of section, e.g. \"Functional status\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionFunctionalStatus.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionFunctionalStatus.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "47420-5",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionFunctionalStatus.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionFunctionalStatus.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"
} ],
"max": "1",
"id": "Composition.section:sectionFunctionalStatus.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:sectionFunctionalStatus.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|4.0.1",
"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:sectionFunctionalStatus.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": "It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.",
"isModifier": false,
"short": "Optional entry used to represent disabilities and functional assessments",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/condition-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/ClinicalImpression", "http://hl7.eu/fhir/hdr/StructureDefinition/observation-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference", "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionFunctionalStatus.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.entry",
"min": 0,
"definition": "Optional entry used to represent disabilities and other conditions that may influence the functional status of the patient. It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties.",
"isModifier": false,
"short": "Functional status condition entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/condition-obl-eu-hdr" ]
} ],
"sliceName": "condition",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionFunctionalStatus.entry:condition",
"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.entry",
"min": 0,
"definition": "Optional entry used to represent functional assessment of the patient.",
"isModifier": false,
"short": "Functional status observation entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/observation-obl-eu-hdr" ]
} ],
"sliceName": "observation",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionFunctionalStatus.entry:observation",
"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|4.0.1",
"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:sectionFunctionalStatus.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:sectionFunctionalStatus.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
}, {
"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": 0,
"definition": "A section carrying textual content of the Hospital Discharge Report as one narrative, used as an alternative to reporting the content of the report when structured sections are not, or only partially available. Either this section or the Hospital course section, or both, shall be present.",
"isModifier": false,
"short": "Complete narrative discharge summary",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionDischargeSummary",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
} ],
"max": "1",
"id": "Composition.section:sectionDischargeSummary",
"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:sectionDischargeSummary.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionDischargeSummary.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionDischargeSummary.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionDischargeSummary.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": 0,
"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 of section, e.g. \"Discharge summary\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionDischargeSummary.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionDischargeSummary.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "18842-5",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeSummary.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeSummary.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"
} ],
"max": "1",
"id": "Composition.section:sectionDischargeSummary.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:sectionDischargeSummary.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|4.0.1",
"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:sectionDischargeSummary.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|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeSummary.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|4.0.1",
"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:sectionDischargeSummary.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:sectionDischargeSummary.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
}, {
"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": 0,
"definition": "Significant information about the course of the hospital stay, describing the sequence of events from admission to discharge in a hospital facility. This section groups the diagnostic summary, significant procedures, pharmacotherapy administered during the stay, medical devices and implants, significant medical test results and the clinical synthesis, and may carry a narrative account of the course of the encounter.",
"isModifier": false,
"short": "Significant information about course of hospital stay",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionHospitalCourse",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionHospitalCourse",
"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:sectionHospitalCourse.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionHospitalCourse.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to this resource or element.",
"isModifier": false,
"short": "Additional notes that apply to this resource or element.",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionHospitalCourse.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionHospitalCourse.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": 0,
"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 of section, e.g. \"Hospital course\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionHospitalCourse.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionHospitalCourse.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "8648-8",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionHospitalCourse.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionHospitalCourse.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",
"requirements": "EHDSDischargeReport.body.courseOfEncounter.generatedNarrative; EHDSDischargeReport.body.courseOfEncounter.note",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionHospitalCourse.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:sectionHospitalCourse.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|4.0.1",
"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:sectionHospitalCourse.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|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionHospitalCourse.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|4.0.1",
"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:sectionHospitalCourse.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:sectionHospitalCourse.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
}, {
"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": 0,
"definition": "All problems and diagnoses that affect care during the inpatient case or are important to be recorded to ensure continuity of care. The diagnostic summary contains a concise, well specified and codeable summary of problems as they were recognised at the end of hospitalisation, after all examinations. Additional detail on a problem may be provided in the patient history section or in the synthesis section.",
"isModifier": false,
"short": "Problems and diagnoses of the hospital stay",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionDiagnosticSummary",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionDiagnosticSummary",
"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:sectionDiagnosticSummary.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionDiagnosticSummary.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionDiagnosticSummary.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionDiagnosticSummary.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": 0,
"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 of section, e.g. \"Diagnostic summary\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionDiagnosticSummary.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionDiagnosticSummary.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "11535-2",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionDiagnosticSummary.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionDiagnosticSummary.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"
} ],
"max": "1",
"id": "Composition.section:sectionDiagnosticSummary.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:sectionDiagnosticSummary.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|4.0.1",
"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:sectionDiagnosticSummary.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.eu/fhir/hdr/StructureDefinition/condition-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionDiagnosticSummary.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|4.0.1",
"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:sectionDiagnosticSummary.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:sectionDiagnosticSummary.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
}, {
"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": 0,
"definition": "Significant surgical and non-surgical procedures performed during hospitalisation which are significant for continuity of care, for example surgery and other instrumental interventions such as endoscopic or intravascular procedures, chemotherapy, radiotherapy, purification methods such as dialysis or hemoperfusion, circulation support methods such as counterpulsation, and the administration of blood derivatives. Purely diagnostic procedures such as MRI or CT are not reported here.",
"isModifier": false,
"short": "Significant procedures performed during the stay",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionSignificantProcedures",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionSignificantProcedures",
"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:sectionSignificantProcedures.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionSignificantProcedures.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionSignificantProcedures.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionSignificantProcedures.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": 0,
"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 of section, e.g. \"Significant procedures\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionSignificantProcedures.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionSignificantProcedures.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "10185-7",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionSignificantProcedures.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionSignificantProcedures.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"
} ],
"max": "1",
"id": "Composition.section:sectionSignificantProcedures.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:sectionSignificantProcedures.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|4.0.1",
"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:sectionSignificantProcedures.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.eu/fhir/hdr/StructureDefinition/procedure-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionSignificantProcedures.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|4.0.1",
"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:sectionSignificantProcedures.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:sectionSignificantProcedures.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
}, {
"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": 0,
"definition": "The patient history of medical device use, describing implanted and external medical devices and equipment on which the health status of the patient depends and of which health professionals need to be aware, for example cardiac pacemakers, implantable defibrillators, prostheses and ferromagnetic bone implants. Devices implanted, explanted or discontinued during the current hospital stay are reported in the Medical devices and implants section.",
"isModifier": false,
"short": "Devices used or implanted before this encounter",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionMedicalDevices",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionMedicalDevices",
"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:sectionMedicalDevices.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionMedicalDevices.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionMedicalDevices.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionMedicalDevices.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": 0,
"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 of section, e.g. \"History of medical device use\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionMedicalDevices.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionMedicalDevices.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "46264-8",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionMedicalDevices.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionMedicalDevices.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"
} ],
"max": "1",
"id": "Composition.section:sectionMedicalDevices.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:sectionMedicalDevices.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|4.0.1",
"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:sectionMedicalDevices.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": "Resources describing the patient history of medical device use.",
"isModifier": false,
"short": "Medical device entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/deviceUseStatement-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/procedure-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionMedicalDevices.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.entry",
"min": 0,
"definition": "It describes the patient history of medical device use.",
"isModifier": false,
"short": "Patient history of medical device use",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/deviceUseStatement-obl-eu-hdr" ]
} ],
"sliceName": "deviceStatement",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionMedicalDevices.entry:deviceStatement",
"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|4.0.1",
"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:sectionMedicalDevices.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:sectionMedicalDevices.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
}, {
"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": 0,
"definition": "Historical procedures performed on or for the patient that are relevant to the current encounter, for example invasive diagnostic procedures such as cardiac catheterisation, therapeutic procedures such as dialysis, surgical procedures such as appendectomy, and further biopsies, counselling, physiotherapy or personal support services. Results of diagnostic procedures are documented in the Significant medical test results section. Procedures performed during the current hospital stay are reported in the Significant procedures section.",
"isModifier": false,
"short": "Past procedures relevant to this encounter",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionProceduresHx",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionProceduresHx",
"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:sectionProceduresHx.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionProceduresHx.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionProceduresHx.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionProceduresHx.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": 0,
"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 of section, e.g. \"History of procedures\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionProceduresHx.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionProceduresHx.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "47519-4",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionProceduresHx.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionProceduresHx.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"
} ],
"max": "1",
"id": "Composition.section:sectionProceduresHx.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:sectionProceduresHx.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|4.0.1",
"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:sectionProceduresHx.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": "Past procedures of the patient that are pertinent to the scope of this document.",
"isModifier": false,
"short": "Past procedure entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/procedure-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionProceduresHx.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.entry",
"min": 0,
"definition": "It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:\r\n1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)\r\n2. Therapeutic procedure: e.g. dialysis;\r\n3. Surgical procedure: e.g. appendectomy\r\n",
"isModifier": false,
"short": "Patient past procedures pertinent to the scope of this document.",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/procedure-obl-eu-hdr" ]
} ],
"sliceName": "procedure",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionProceduresHx.entry:procedure",
"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|4.0.1",
"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:sectionProceduresHx.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:sectionProceduresHx.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
}, {
"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": 0,
"definition": "Selected drug treatment during hospitalisation, namely medicinal products that were administered during the stay and whose administration was already discontinued before discharge. Only products that are important for continuity of care are listed, for example antibiotics other than completely routine ones, or corticosteroids in high doses. Medicinal products whose administration continues after discharge are recorded in the Hospital discharge medications section, and where their administration started during the stay and is also recommended afterwards they are listed there as well.",
"isModifier": false,
"short": "Drug treatment discontinued before discharge",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionPharmacotherapy",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionPharmacotherapy",
"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:sectionPharmacotherapy.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionPharmacotherapy.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionPharmacotherapy.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionPharmacotherapy.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": 0,
"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 of section, e.g. \"Pharmacotherapy\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionPharmacotherapy.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionPharmacotherapy.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "87232-5",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionPharmacotherapy.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionPharmacotherapy.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"
} ],
"max": "1",
"id": "Composition.section:sectionPharmacotherapy.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:sectionPharmacotherapy.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|4.0.1",
"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:sectionPharmacotherapy.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": "Medication statements, requests, dispenses or administrations documenting the significant drug treatment during the stay.",
"isModifier": false,
"short": "Pharmacotherapy entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/medicationStatement-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/medicationRequest-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/medicationDispense-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/medicationAdministration-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionPharmacotherapy.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.entry",
"min": 0,
"definition": "Significant medication treatments during encounter.",
"isModifier": false,
"short": "Medication Use",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/medicationStatement-obl-eu-hdr" ]
} ],
"sliceName": "medicationStatement",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionPharmacotherapy.entry:medicationStatement",
"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|4.0.1",
"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:sectionPharmacotherapy.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:sectionPharmacotherapy.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
}, {
"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": 0,
"definition": "Implants and medical devices used during the hospital stay that affected or may affect the provision of health services, meaning diagnosis and treatment, including devices that were explanted or whose use was stopped during hospitalisation. The patient history of earlier medical device use is reported in the History of medical device use section.",
"isModifier": false,
"short": "Devices and implants during the hospital stay",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionImplantedDevices",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionImplantedDevices",
"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:sectionImplantedDevices.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionImplantedDevices.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionImplantedDevices.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionImplantedDevices.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": 0,
"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 of section, e.g. \"Medical devices and implants\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionImplantedDevices.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionImplantedDevices.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "57080-4",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionImplantedDevices.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionImplantedDevices.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"
} ],
"max": "1",
"id": "Composition.section:sectionImplantedDevices.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:sectionImplantedDevices.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|4.0.1",
"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:sectionImplantedDevices.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.eu/fhir/hdr/StructureDefinition/deviceUseStatement-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/procedure-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionImplantedDevices.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|4.0.1",
"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:sectionImplantedDevices.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:sectionImplantedDevices.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
}, {
"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": 0,
"definition": "Significant results of functional, diagnostic, including laboratory, and imaging examinations performed during the encounter which are needed to ensure continuity of care. Examinations that were ordered but whose results have not yet been delivered may also be reported, and are presented separately from results already delivered.",
"isModifier": false,
"short": "Significant medical test results of the stay",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionSignificantResults",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionSignificantResults",
"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:sectionSignificantResults.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionSignificantResults.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionSignificantResults.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionSignificantResults.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": 0,
"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 of section, e.g. \"Significant medical test results\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionSignificantResults.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionSignificantResults.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "30954-2",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionSignificantResults.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionSignificantResults.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"
} ],
"max": "1",
"id": "Composition.section:sectionSignificantResults.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:sectionSignificantResults.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|4.0.1",
"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:sectionSignificantResults.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": "Significant medical test results slice",
"isModifier": false,
"short": "Significant medical test results",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/observation-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/laboratoryObservation-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionSignificantResults.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.entry",
"min": 0,
"definition": "Results collected on the patient or produced on in-vitro biologic specimens.",
"isModifier": false,
"short": "Medical test results",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/laboratoryObservation-obl-eu-hdr" ]
} ],
"sliceName": "results-medicalTestResult",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionSignificantResults.entry:results-medicalTestResult",
"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.entry",
"min": 0,
"definition": "DiagnosticReport resource to represent diagnostic test and procedure reports in the Hospital Discharge Report.",
"isModifier": false,
"short": "Diagnostic report",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/base/StructureDefinition/diagnosticReport-eu-core" ]
} ],
"sliceName": "results-diagnosticReport",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionSignificantResults.entry:results-diagnosticReport",
"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|4.0.1",
"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:sectionSignificantResults.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:sectionSignificantResults.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
}, {
"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": 0,
"definition": "Clinical synthesis of the hospital stay, describing the reasons for and the course of hospitalisation, clustered by the conditions that were managed. In clinically complex cases the synthesis may conclude with clinical reasoning, such as differential diagnostic considerations or an explanation of the clinical context.",
"isModifier": false,
"short": "Clinical synthesis of the hospital stay",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionSynthesis",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionSynthesis",
"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:sectionSynthesis.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionSynthesis.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionSynthesis.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionSynthesis.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": 0,
"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 of section, e.g. \"Synthesis\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionSynthesis.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionSynthesis.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "67781-5",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionSynthesis.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionSynthesis.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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionSynthesis.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:sectionSynthesis.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|4.0.1",
"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:sectionSynthesis.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|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionSynthesis.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|4.0.1",
"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:sectionSynthesis.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:sectionSynthesis.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
}, {
"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": 0,
"definition": "The plan of care after discharge, containing a narrative description of the expectations for care including proposals, goals and order requests for monitoring, tracking or improving the condition of the patient. Several care plans may be reported, each linked to the conditions whose management or mitigation it addresses. Other recommendations and advice given at discharge are also reported here, for example to consider hip replacement, to reduce the number of cigarettes or to stop smoking, or to increase physical exercise. Medication recommended for the period after discharge is reported in the Hospital discharge medications section.",
"isModifier": false,
"short": "Plan of care and recommendations after discharge",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionPlanOfCare",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionPlanOfCare",
"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:sectionPlanOfCare.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionPlanOfCare.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionPlanOfCare.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionPlanOfCare.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": 0,
"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 of section, e.g. \"Plan of care\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionPlanOfCare.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionPlanOfCare.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "18776-5",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionPlanOfCare.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionPlanOfCare.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",
"requirements": "EHDSDischargeReport.body.carePlan.generatedNarrative",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionPlanOfCare.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:sectionPlanOfCare.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|4.0.1",
"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:sectionPlanOfCare.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.eu/fhir/hdr/StructureDefinition/carePlan-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionPlanOfCare.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|4.0.1",
"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:sectionPlanOfCare.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:sectionPlanOfCare.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
}, {
"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": 0,
"definition": "Summary information on the medication recommended for the period after discharge, defining the medicinal products that the patient is intended to take or to stop and indicating for each whether it is unchanged, changed, newly started or discontinued, together with the reason for a change. Drug treatment that was administered during the stay and already discontinued before discharge is reported in the Pharmacotherapy section.",
"isModifier": false,
"short": "Medication intended after discharge",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionDischargeMedications",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeMedications",
"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:sectionDischargeMedications.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionDischargeMedications.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to this resource or element.",
"isModifier": false,
"short": "Additional notes that apply to this resource or element.",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeMedications.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionDischargeMedications.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": 0,
"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 of section, e.g. \"Hospital discharge medications\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionDischargeMedications.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionDischargeMedications.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "75311-1",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeMedications.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeMedications.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",
"requirements": "EHDSDischargeReport.body.medicationSummary.generatedNarrative; EHDSDischargeReport.body.medicationSummary.note",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeMedications.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:sectionDischargeMedications.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|4.0.1",
"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:sectionDischargeMedications.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.eu/fhir/hdr/StructureDefinition/medicationRequest-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/medicationDispense-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/medicationStatement-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeMedications.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|4.0.1",
"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:sectionDischargeMedications.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:sectionDischargeMedications.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
}, {
"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": 0,
"definition": "Relevant allergies and intolerances of the patient, primarily those newly identified during the hospital stay, describing the kind of reaction, for example rash or anaphylaxis, preferably the agent or allergen causing it, and optionally the criticality and the certainty of the allergy. Any historical allergy or adverse reaction that is still active or relevant for continuity of care is also listed.",
"isModifier": false,
"short": "Relevant allergies and intolerances",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionAllergies",
"max": "1",
"id": "Composition.section:sectionAllergies",
"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:sectionAllergies.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionAllergies.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionAllergies.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionAllergies.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": 0,
"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 of section, e.g. \"Allergies and intolerances\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionAllergies.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionAllergies.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "48765-2",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionAllergies.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionAllergies.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"
} ],
"max": "1",
"id": "Composition.section:sectionAllergies.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:sectionAllergies.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|4.0.1",
"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:sectionAllergies.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": "Relevant allergies or intolerances of the patient.",
"isModifier": false,
"short": "Allergy or intolerance entry",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/allergyIntolerance-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"max": "*",
"id": "Composition.section:sectionAllergies.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.entry",
"min": 0,
"definition": "It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.",
"isModifier": false,
"short": "Relevant allergies or intolerances for that patient.",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/allergyIntolerance-obl-eu-hdr" ]
} ],
"sliceName": "allergyOrIntolerance",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionAllergies.entry:allergyOrIntolerance",
"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|4.0.1",
"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:sectionAllergies.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:sectionAllergies.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
}, {
"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": 0,
"definition": "The health history of the patient, or anamnesis, in narrative form. It may provide a synthetic anamnesis, such as a chronological summary of clustered clinical information describing the phases of a pathology, as well as anecdotal evidence that clinicians can collect from the patient. Only history that is important for continuity of care is reported, complementing the diagnostic summary. Structured history is recorded in the dedicated sections for problems, procedures, medical devices and immunizations.",
"isModifier": false,
"short": "Narrative patient health history (anamnesis)",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionPatientHx",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionPatientHx",
"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:sectionPatientHx.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionPatientHx.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to this resource or element.",
"isModifier": false,
"short": "Additional notes that apply to this resource or element.",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionPatientHx.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionPatientHx.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": 0,
"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 of section, e.g. \"Patient health history\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionPatientHx.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionPatientHx.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "11329-0",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionPatientHx.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionPatientHx.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",
"requirements": "EHDSDischargeReport.body.patientHistory.generatedNarrative",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionPatientHx.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:sectionPatientHx.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|4.0.1",
"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:sectionPatientHx.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|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionPatientHx.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|4.0.1",
"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:sectionPatientHx.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:sectionPatientHx.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
}, {
"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": 0,
"definition": "Clinical problems and conditions of the patient that are currently being monitored and remain relevant after discharge, including conditions the patient suffered in the past and still suffers from. Unlike the diagnostic summary, this section may carry a broader description of a condition and its progress, including treatment and the response of the patient to treatment. Only conditions important for continuity of care are listed.",
"isModifier": false,
"short": "Problems currently being monitored",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionProblems",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionProblems",
"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:sectionProblems.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionProblems.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionProblems.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionProblems.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": 0,
"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 of section, e.g. \"Problem list\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionProblems.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionProblems.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "11450-4",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionProblems.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionProblems.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"
} ],
"max": "1",
"id": "Composition.section:sectionProblems.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:sectionProblems.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|4.0.1",
"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:sectionProblems.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": "It lists and describes clinical problems or conditions currently being monitored for the patient.",
"isModifier": false,
"short": "Clinical problems or conditions currently being monitored for the patient.",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/condition-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionProblems.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.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.eu/fhir/hdr/StructureDefinition/condition-obl-eu-hdr" ]
} ],
"sliceName": "problem",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionProblems.entry:problem",
"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|4.0.1",
"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:sectionProblems.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:sectionProblems.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
}, {
"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": 0,
"definition": "The immunization status and the vaccination history of the patient. The primary purpose of this section is to communicate the current immunization status, and it may contain the entire vaccination history relevant to the period being summarised, including the disease or agent targeted, the vaccine or its components, the dose within a series, the date of administration and any planned next dose.",
"isModifier": false,
"short": "Immunization status and vaccination history",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionImmunizations",
"max": "1",
"id": "Composition.section:sectionImmunizations",
"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:sectionImmunizations.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionImmunizations.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionImmunizations.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionImmunizations.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": 0,
"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 of section, e.g. \"Immunizations\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionImmunizations.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionImmunizations.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "11369-6",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionImmunizations.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionImmunizations.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"
} ],
"max": "1",
"id": "Composition.section:sectionImmunizations.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:sectionImmunizations.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|4.0.1",
"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:sectionImmunizations.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": "It defines the patient's current immunization status and pertinent immunization history.\r\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\r\nIt may contain the entire immunization history that is relevant to the period of time being summarized.",
"isModifier": false,
"short": "Patient's immunization status and pertinent history.",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "resolve()",
"type": "type"
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/immunization-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"max": "*",
"id": "Composition.section:sectionImmunizations.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.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.eu/fhir/hdr/StructureDefinition/immunization-obl-eu-hdr" ]
} ],
"sliceName": "immunization",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionImmunizations.entry:immunization",
"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|4.0.1",
"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:sectionImmunizations.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:sectionImmunizations.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
}, {
"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": 0,
"definition": "Details of the discharge of the patient, comprising the discharge status or disposition and the condition of the patient at discharge. Structured information should be provided, and where it is not available at least a discharge summary note should be present. The discharge date, the type of destination such as home, another hospital or a nursing home, discharge against medical advice, and the destination organisation are recorded in the encounter.",
"isModifier": false,
"short": "Discharge status and disposition of the patient",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionDischargeDetails",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeDetails",
"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:sectionDischargeDetails.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionDischargeDetails.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to this resource or element.",
"isModifier": false,
"short": "Additional notes that apply to this resource or element.",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeDetails.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionDischargeDetails.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": 0,
"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 of section, e.g. \"Discharge details\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionDischargeDetails.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionDischargeDetails.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "8650-4",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeDetails.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeDetails.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",
"requirements": "EHDSDischargeReport.body.dischargeDetails.generatedNarrative; EHDSDischargeReport.body.dischargeDetails.note",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "1",
"id": "Composition.section:sectionDischargeDetails.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:sectionDischargeDetails.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|4.0.1",
"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:sectionDischargeDetails.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|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionDischargeDetails.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|4.0.1",
"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:sectionDischargeDetails.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:sectionDischargeDetails.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
}, {
"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": 0,
"definition": "Documents and attachments associated with this report, listed as a library of source material referenced from the report, for example scanned source documents, images, or reports in PDF form. Implementations may define what kind of attachments are allowed and may ignore unexpected attachments for security reasons.",
"isModifier": false,
"short": "Library of attachments",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"sliceName": "sectionAttachments",
"max": "1",
"id": "Composition.section:sectionAttachments",
"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:sectionAttachments.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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Composition.section:sectionAttachments.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.section.extension",
"min": 0,
"definition": "Additional notes that apply to the section (but not to specific resource).",
"isModifier": false,
"short": "Additional notes that apply to the section (but not to specific resource).",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/note" ]
} ],
"sliceName": "section-note",
"max": "*",
"id": "Composition.section:sectionAttachments.extension:section-note",
"condition": [ "ele-1" ],
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"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:sectionAttachments.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": 0,
"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 of section, e.g. \"Attachments\" for ToC",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section:sectionAttachments.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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1",
"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:sectionAttachments.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.",
"patternCodeableConcept": {
"coding": [ {
"code": "77599-9",
"system": "http://loinc.org"
} ]
},
"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|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "*",
"id": "Composition.section:sectionAttachments.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|4.0.1" ]
} ],
"max": "1",
"id": "Composition.section:sectionAttachments.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"
} ],
"max": "1",
"id": "Composition.section:sectionAttachments.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:sectionAttachments.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|4.0.1",
"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:sectionAttachments.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/DocumentReference", "http://hl7.org/fhir/StructureDefinition/Binary" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr|1.0.0"
} ]
} ],
"max": "*",
"id": "Composition.section:sectionAttachments.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|4.0.1",
"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:sectionAttachments.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:sectionAttachments.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
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "1.0.0"
} ]
},
"status": "active",
"id": "632c7bb5-c363-41d9-8242-22ce15dbaef4",
"kind": "resource",
"url": "http://hl7.eu/fhir/hdr/StructureDefinition/composition-obl-eu-hdr",
"version": "1.0.0",
"differential": {
"element": [ {
"id": "Composition.language",
"path": "Composition.language",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.extension:informationRecipient",
"path": "Composition.extension",
"sliceName": "informationRecipient"
}, {
"id": "Composition.extension:informationRecipient.value[x]",
"path": "Composition.extension.value[x]",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/practitionerRole-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/practitioner-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/device-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/patient-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/relatedPerson-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/organization-obl-eu-hdr" ]
} ]
}, {
"id": "Composition.identifier",
"path": "Composition.identifier",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.status",
"path": "Composition.status",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.type",
"path": "Composition.type",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.category",
"path": "Composition.category",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.subject",
"path": "Composition.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/patient-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.encounter",
"path": "Composition.encounter",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/encounter-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.date",
"path": "Composition.date",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.author",
"path": "Composition.author",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/practitioner-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/practitionerRole-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/device-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/organization-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.title",
"path": "Composition.title",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.attester",
"path": "Composition.attester",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.attester.mode",
"path": "Composition.attester.mode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.attester.time",
"path": "Composition.attester.time",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.attester.party",
"path": "Composition.attester.party",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/practitioner-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/practitionerRole-obl-eu-hdr", "http://hl7.eu/fhir/hdr/StructureDefinition/organization-obl-eu-hdr" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:display"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.custodian",
"path": "Composition.custodian",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.event.period",
"path": "Composition.event.period",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
} ]
}, {
"id": "Composition.section",
"path": "Composition.section",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.section.text",
"path": "Composition.section.text",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.section:sectionAlert",
"path": "Composition.section",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ],
"sliceName": "sectionAlert"
}, {
"id": "Composition.section:sectionAlert.text",
"path": "Composition.section.text",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:process"
}, {
"url": "actor",
"valueCanonical": "https://www.xt-ehr.eu/specifications/fhir/actor-consumer"
} ]
} ]
}, {
"id": "Composition.section:sectionAlert.entry",
"path": "Composition.section.entry",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.eu/fhir/hdr/StructureDefinition/flag-obl-eu-hdr", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHOULD:able-to-populate"
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