description: The US Core ADI DocumentReference Profile inherits from the FHIR [DocumentReference](https://hl7.org/fhir/R4/documentreference.html) resource; refer to it for scope and usage definitions. This profile and the [US Core Observation ADI Documentation Profile](StructureDefinition-us-core-observation-adi-documentation.html) meet the [U.S. Core Data for Interoperability (USCDI)](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi) *Advance Directive Observation* Data Element requirements. It sets minimum expectations for searching and fetching patient Advance Directive Information (ADI) documents using the DocumentReference resource. Examples of advance healthcare directive documents include physician order for life sustaining treatment (POLST), do not resuscitate order (DNR), and medical power of attorney. In addition to the document contents, it communicates the type of advance directive document, the author, the verifier, and other properties. To represent whether advance directive documents exist for a patient, see the US Core Observation ADI Documentation Profile. This profile sets minimum expectations for searching and fetching patient ADI documents using the DocumentReference resource. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.
package_name: hl7.fhir.us.core
derivation: constraint
name: USCoreADIDocumentReferenceProfile
type: DocumentReference
elements:
  category:
    mustSupport: true
    index: 4
    slicing:
      rules: open
      discriminator:
      - {path: $this, type: value}
      min: 1
      slices:
        adi:
          match: {}
          schema:
            short: Categorization of ADI document"
            binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.25'}
            mustSupport: true
            index: 5
  date: {mustSupport: true, index: 7}
  content:
    mustSupport: true
    index: 10
    elements:
      attachment:
        constraint:
          us-core-6: {human: DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present., severity: error, expression: url.exists() or data.exists()}
        mustSupport: true
        index: 11
        elements:
          contentType: {mustSupport: true, index: 12}
          data: {mustSupport: true, index: 13}
          url: {mustSupport: true, index: 14}
      format:
        binding: {strength: extensible, valueSet: 'http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes'}
        mustSupport: true
        index: 15
  type:
    binding: {strength: extensible, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.57'}
    mustSupport: true
    index: 3
  author:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/Device', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson']
    index: 8
  extension:
    type: Extension
    short: Authentication Time"
    mustSupport: true
    url: http://hl7.org/fhir/us/core/StructureDefinition/us-core-authentication-time
    index: 0
    slicing:
      slices:
        authenticationTime:
          match: {}
          schema: {type: Extension, short: Authentication Time", mustSupport: true, url: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-authentication-time', index: 0}
          min: 0
          max: 1
  status:
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/document-reference-status'}
    mustSupport: true
    index: 2
  identifier: {mustSupport: true, index: 1}
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/Device', 'http://hl7.org/fhir/StructureDefinition/Group', 'http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient']
    index: 6
  authenticator:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole']
    index: 9
package_version: 8.0.0-ballot
extensions:
  authenticationTime: {url: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-authentication-time', min: 0, max: 1, type: Extension, short: Authentication Time", mustSupport: true, index: 0}
class: profile
kind: resource
url: http://hl7.org/fhir/us/core/StructureDefinition/us-core-adi-documentreference
base: http://hl7.org/fhir/StructureDefinition/DocumentReference
version: 8.0.0-ballot
required: [subject, type, category]