description: This profile defines constraints that represent common administrative and demographic concepts for transitions of care information used in US Realm clinical documents.
package_name: hl7.fhir.us.pacio-toc.r4
derivation: constraint
name: TOCComposition
type: Composition
elements:
  category:
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 42348-3, system: 'http://loinc.org'}
    index: 3
  date: {mustSupport: true, index: 6}
  encounter:
    type: Reference
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|6.1.0']
    index: 5
  section:
    array: true
    min: 4
    index: 11
    elements:
      text: {mustSupport: true, index: 12}
    required: [text]
    slicing:
      rules: open
      ordered: false
      description: Slice based on $this value
      discriminator:
      - {path: code, type: value}
      min: 4
      slices:
        reason_for_visit:
          match:
            code:
              coding:
              - {code: 29299-5, system: 'http://loinc.org', display: Reason for visit Narrative}
          schema:
            short: Reason for Visit (Ambulatory)
            mustSupport: true
            index: 61
            elements:
              title: {mustSupport: true, index: 62}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 29299-5, system: 'http://loinc.org', display: Reason for visit Narrative}
                index: 63
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation', 'http://hl7.org/fhir/StructureDefinition/Observation', 'http://hl7.org/fhir/us/ccda/StructureDefinition/Discharge-Summary|2.0.0-ballot', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure|6.1.0']
                index: 64
            required: [title, code]
        functional_status:
          match:
            code:
              coding:
              - {code: 54522-8, system: 'http://loinc.org', display: Functional status}
          schema:
            short: Functional Status
            mustSupport: true
            index: 25
            elements:
              title: {mustSupport: true, index: 26}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 54522-8, system: 'http://loinc.org', display: Functional status}
                index: 27
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/StructureDefinition/Observation', 'http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-narrative-history-of-status', 'http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-use-of-device']
                index: 28
            required: [title, code]
        medication_equipment:
          match:
            code:
              coding:
              - {code: 57829-4, system: 'http://loinc.org', display: Prescription for medical equipment or product}
          schema:
            short: Medication Equipment
            mustSupport: true
            index: 37
            elements:
              title: {mustSupport: true, index: 38}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 57829-4, system: 'http://loinc.org', display: Prescription for medical equipment or product}
                index: 39
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/StructureDefinition/Device']
                index: 40
            required: [title, code]
        problems:
          match:
            code:
              coding:
              - {code: 46019-6, system: 'http://loinc.org', display: Diseases or conditions Set}
          schema:
            short: Problem
            mustSupport: true
            _required: true
            index: 49
            elements:
              title: {mustSupport: true, index: 50}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 46019-6, system: 'http://loinc.org', display: Diseases or conditions Set}
                index: 51
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation|6.1.0']
                index: 52
            required: [title, code]
        social_history:
          match:
            code:
              coding:
              - {code: 10166-7, system: 'http://loinc.org', display: History of Social function Narrative}
          schema:
            short: Social History
            mustSupport: true
            index: 69
            elements:
              title: {mustSupport: true, index: 70}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 10166-7, system: 'http://loinc.org', display: History of Social function Narrative}
                index: 71
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus|6.1.0', 'http://hl7.org/fhir/us/dental-data-exchange/StructureDefinition/dental-bundle', 'http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-narrative-history-of-status', 'http://hl7.org/fhir/uv/ips/StructureDefinition/Composition-uv-ips']
                index: 72
            required: [title, code]
        behavioral_health:
          match:
            code:
              coding:
              - {code: 54511-1, system: 'http://loinc.org', display: Behavior}
          schema:
            short: Behavioral Health
            mustSupport: true
            index: 21
            elements:
              title: {mustSupport: true, index: 22}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 54511-1, system: 'http://loinc.org', display: Behavior}
                index: 23
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation|6.1.0']
                index: 24
            required: [title, code]
        instructions:
          match:
            code:
              coding:
              - {code: 59271-7, system: 'http://loinc.org', display: Hospital discharge summary panel}
          schema:
            short: Discharge Instructions
            mustSupport: true
            index: 33
            elements:
              title: {mustSupport: true, index: 34}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 59271-7, system: 'http://loinc.org', display: Hospital discharge summary panel}
                index: 35
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|6.1.0']
                index: 36
            required: [title, code]
        medications:
          match:
            code:
              coding:
              - {code: 52471-0, system: 'http://loinc.org', display: Medications}
          schema:
            short: Medications
            mustSupport: true
            _required: true
            index: 41
            elements:
              title: {mustSupport: true, index: 42}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 52471-0, system: 'http://loinc.org', display: Medications}
                index: 43
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/StructureDefinition/List']
                index: 44
            required: [title, code]
        vital_signs:
          match:
            code:
              coding:
              - {code: LP30605-7, system: 'http://loinc.org', display: Vital signs}
          schema:
            short: Vital Signs
            mustSupport: true
            index: 73
            elements:
              title: {mustSupport: true, index: 74}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: LP30605-7, system: 'http://loinc.org', display: Vital signs}
                index: 75
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs|6.1.0']
                index: 76
            required: [title, code]
        immunizations:
          match:
            code:
              coding:
              - {code: 82593-5, system: 'http://loinc.org', display: Immunization summary report}
          schema:
            short: Immunizations
            mustSupport: true
            index: 29
            elements:
              title: {mustSupport: true, index: 30}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 82593-5, system: 'http://loinc.org', display: Immunization summary report}
                index: 31
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization|6.1.0']
                index: 32
            required: [title, code]
        reason_for_referral:
          match:
            code:
              coding:
              - {code: 42349-1, system: 'http://loinc.org', display: Reason for referral (narrative)}
          schema:
            short: Reason for Referral
            mustSupport: true
            index: 57
            elements:
              title: {mustSupport: true, index: 58}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 42349-1, system: 'http://loinc.org', display: Reason for referral (narrative)}
                index: 59
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation', 'http://hl7.org/fhir/StructureDefinition/Observation', 'http://hl7.org/fhir/us/ccda/StructureDefinition/Discharge-Summary|2.0.0-ballot', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure|6.1.0']
                index: 60
            required: [title, code]
        procedures:
          match:
            code:
              coding:
              - {code: 28570-0, system: 'http://loinc.org', display: Procedure note}
          schema:
            short: Procedures
            mustSupport: true
            index: 53
            elements:
              title: {mustSupport: true, index: 54}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 28570-0, system: 'http://loinc.org', display: Procedure note}
                index: 55
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure']
                index: 56
            required: [title, code]
        allergies:
          match:
            code:
              coding:
              - {code: 48765-2, system: 'http://loinc.org', display: Allergies and adverse reactions Document}
          schema:
            short: Allergies
            mustSupport: true
            _required: true
            index: 17
            elements:
              title: {mustSupport: true, index: 18}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 48765-2, system: 'http://loinc.org', display: Allergies and adverse reactions Document}
                index: 19
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|6.1.0']
                index: 20
            required: [title, code]
        advance_directives:
          match:
            code:
              coding:
              - {code: 42348-3, system: 'http://loinc.org', display: Advance healthcare directives}
          schema:
            short: Advance Directives
            mustSupport: true
            index: 13
            elements:
              title: {mustSupport: true, index: 14}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 42348-3, system: 'http://loinc.org', display: Advance healthcare directives}
                index: 15
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PACPComposition']
                index: 16
            required: [title, code]
        plan_of_care:
          match:
            code:
              coding:
              - {code: 74449-0, system: 'http://loinc.org', display: Patient plan of care - recommended IHE set}
          schema:
            short: Plan of Care
            mustSupport: true
            index: 45
            elements:
              title: {mustSupport: true, index: 46}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 74449-0, system: 'http://loinc.org', display: Patient plan of care - recommended IHE set}
                index: 47
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan|6.1.0']
                index: 48
            required: [title, code]
        results:
          match:
            code:
              coding:
              - {code: 19146-0, system: 'http://loinc.org', display: Referral lab test results}
          schema:
            short: Recent Test Results
            mustSupport: true
            _required: true
            index: 65
            elements:
              title: {mustSupport: true, index: 66}
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 19146-0, system: 'http://loinc.org', display: Referral lab test results}
                index: 67
              entry:
                type: Reference
                refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result|6.1.0']
                index: 68
            required: [title, code]
  type:
    binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/ValueSet/doc-typecodes'}
    mustSupport: true
    index: 2
  title: {mustSupport: true, index: 8}
  author:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/Device', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole', 'http://hl7.org/fhir/StructureDefinition/RelatedPerson', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole|6.1.0', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0']
    index: 7
  custodian:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|6.1.0']
    index: 10
  language: {mustSupport: true, index: 0}
  identifier: {mustSupport: true, index: 1}
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0']
    index: 4
  confidentiality: {index: 9}
package_version: 1.0.0-ballot
class: profile
kind: resource
url: http://hl7.org/fhir/us/pacio-toc/StructureDefinition/TOC-Composition
base: http://hl7.org/fhir/StructureDefinition/clinicaldocument
version: 1.0.0-ballot
required: [identifier, subject, custodian, language]