description: This profile defines a set of constraints to the FHIR Composition resource for use in Ontario Patient Summaries (PS-ON). It refines constraints applied to the Composition resource by the PS-CA project.\r\nA Canadian Patient Summary (PS-CA) document is an electronic health record extract containing essential healthcare information about a subject of care. It is informed by the IPS-UV Composition profile, but differs in its application of MS flags on some of the sections to allow for jurisdictional implementors flexibility in what sections systems must support in order to show conformance to their respective patient summaries.\r\nThe PS-CA dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. Its informed by the requirements specified in EN 17269 and ISO/DIS 27269, it is designed for supporting the international use case scenario for ‘unplanned, cross border care’, but is also designed to support a variety of use cases for cross-jurisdiction exchange. It is intended to guide implementation nationally while ensuring international exchange of patient summaries is not impeded.\r\n\r\nThis profile is based on the ClinicalDocument profile from the base R4 FHIR standard. package_name: ca.on.oh.patient-summary derivation: constraint name: CompositionPSON type: Composition elements: category: mustSupport: true index: 8 extensions: ext-LOINC-ontology-axis: {url: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis', min: 0, max: 1, type: Extension, isModifier: false, index: 10} elements: extension: index: 9 slicing: rules: open discriminator: - {path: url, type: value} min: 0 slices: ext-LOINC-ontology-axis: match: {url: null} schema: {type: Extension, isModifier: false, url: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis', index: 10} min: 0 max: 1 coding: mustSupport: true index: 11 elements: system: {mustSupport: true, index: 12} code: {mustSupport: true, index: 13} display: {mustSupport: true, index: 14} slicing: rules: open discriminator: - {path: $this, type: pattern} min: null slices: sliceCategory-type-of-service: match: {} schema: mustSupport: true index: 15 extensions: ext-LOINC-ontology-axis: url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis type: Extension isModifier: false mustSupport: true index: 17 elements: value[x]: elements: code: pattern: {type: Code, value: 74478-9} index: 18 display: pattern: {type: String, value: Type of Service} index: 19 elements: extension: index: 16 slicing: rules: open discriminator: - {path: url, type: value} min: 1 slices: ext-LOINC-ontology-axis: match: {url: null} schema: type: Extension isModifier: false mustSupport: true url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis index: 17 elements: value[x]: elements: code: pattern: {type: Code, value: 74478-9} index: 18 display: pattern: {type: String, value: Type of Service} index: 19 coding: mustSupport: true index: 20 elements: system: pattern: {type: Uri, value: 'http://loinc.org'} mustSupport: true index: 21 code: {mustSupport: true, index: 22} display: pattern: {type: String, value: Patient summary} mustSupport: true index: 23 required: [display, system, code] required: [extension, coding] sliceCategory-kind-of-document: match: {} schema: mustSupport: true index: 24 extensions: ext-LOINC-ontology-axis: url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis type: Extension isModifier: false mustSupport: true index: 26 elements: value[x]: elements: code: pattern: {type: Code, value: 74477-1} index: 27 display: pattern: {type: String, value: Kind of document} index: 28 elements: extension: index: 25 slicing: rules: open discriminator: - {path: url, type: value} min: 1 slices: ext-LOINC-ontology-axis: match: {url: null} schema: type: Extension isModifier: false mustSupport: true url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis index: 26 elements: value[x]: elements: code: pattern: {type: Code, value: 74477-1} index: 27 display: pattern: {type: String, value: Kind of document} index: 28 coding: mustSupport: true index: 29 elements: system: pattern: {type: Uri, value: 'http://loinc.org'} mustSupport: true index: 30 code: pattern: {type: Code, value: LP173418-7} mustSupport: true index: 31 display: pattern: {type: String, value: Note} mustSupport: true index: 32 required: [display, system, code] required: [extension, coding] sliceCategory-subject-matter-domain: match: {} schema: mustSupport: true index: 33 extensions: ext-LOINC-ontology-axis: url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis type: Extension isModifier: false mustSupport: true index: 35 elements: value[x]: elements: code: pattern: {type: Code, value: 74480-5} index: 36 display: pattern: {type: String, value: Subject matter domain} index: 37 elements: extension: index: 34 slicing: rules: open discriminator: - {path: url, type: value} min: 1 slices: ext-LOINC-ontology-axis: match: {url: null} schema: type: Extension isModifier: false mustSupport: true url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis index: 35 elements: value[x]: elements: code: pattern: {type: Code, value: 74480-5} index: 36 display: pattern: {type: String, value: Subject matter domain} index: 37 coding: mustSupport: true index: 38 elements: system: pattern: {type: Uri, value: 'http://loinc.org'} mustSupport: true index: 39 code: pattern: {type: Code, value: CGTA1009-1} mustSupport: true index: 40 display: pattern: {type: String, value: Unspecified} mustSupport: true index: 41 required: [display, system, code] required: [extension, coding] sliceCategory-role: match: {} schema: index: 42 extensions: ext-LOINC-ontology-axis: url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis type: Extension isModifier: false mustSupport: true index: 44 elements: value[x]: elements: code: pattern: {type: Code, value: 74479-7} index: 45 display: pattern: {type: String, value: Role} index: 46 elements: extension: index: 43 slicing: rules: open discriminator: - {path: url, type: value} min: 1 slices: ext-LOINC-ontology-axis: match: {url: null} schema: type: Extension isModifier: false mustSupport: true url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis index: 44 elements: value[x]: elements: code: pattern: {type: Code, value: 74479-7} index: 45 display: pattern: {type: String, value: Role} index: 46 coding: mustSupport: true index: 47 elements: system: pattern: {type: Uri, value: 'http://loinc.org'} mustSupport: true index: 48 code: pattern: {type: Code, value: CGTA4001-1} mustSupport: true index: 49 display: pattern: {type: String, value: Unspecified} mustSupport: true index: 50 required: [display, system, code] required: [extension, coding] sliceCategory-setting: match: {} schema: mustSupport: true index: 51 extensions: ext-LOINC-ontology-axis: {url: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis', min: 1, max: 1, type: Extension, isModifier: false, mustSupport: true, index: 53} elements: extension: index: 52 slicing: rules: open discriminator: - {path: url, type: value} min: 1 slices: ext-LOINC-ontology-axis: match: {url: null} schema: {type: Extension, isModifier: false, mustSupport: true, url: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis', index: 53} min: 1 max: 1 coding: mustSupport: true index: 54 elements: system: pattern: {type: Uri, value: 'http://loinc.org'} mustSupport: true index: 55 code: pattern: {type: Code, value: CGTA5001-1} mustSupport: true index: 56 display: pattern: {type: String, value: Unspecified} mustSupport: true index: 57 required: [display, system, code] required: [extension, coding] date: {mustSupport: true, index: 61} meta: mustSupport: true index: 0 elements: profile: {mustSupport: true, index: 1} required: [profile] encounter: {index: 60} section: short: Sections composing the PS mustSupport: true index: 78 elements: code: {type: CodeableConcept, mustSupport: true, index: 79} text: {mustSupport: true, index: 80} required: [text, code] slicing: rules: open ordered: false discriminator: - {path: code, type: pattern} min: 1 slices: sectionMedications: match: code: coding: - {code: 10160-0, system: 'http://loinc.org'} schema: short: PS-ON Medication Summary Section mustSupport: true _required: true index: 81 elements: title: {short: Medication Summary section, mustSupport: true, index: 82} code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 10160-0, system: 'http://loinc.org'} index: 83 text: {mustSupport: true, index: 84} entry: short: Medications relevant for the scope of the patient summary mustSupport: true index: 85 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: medicationInformation: match: {} schema: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-medicationrequest', 'http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-medicationstatement'] _required: true index: 86 min: 1 emptyReason: {mustSupport: false, index: 87} section: {mustSupport: false, index: 88} required: [entry, text, title, code] sectionAllergies: match: code: coding: - {code: 48765-2, system: 'http://loinc.org'} schema: short: PS-ON Allergies and Intolerances Section mustSupport: true _required: true index: 89 elements: title: {mustSupport: true, index: 90} code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 48765-2, system: 'http://loinc.org'} index: 91 text: {mustSupport: true, index: 92} entry: short: Relevant allergies or intolerances (conditions) for that patient. mustSupport: true index: 93 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: allergyOrIntolerance: match: {} schema: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-allergyintolerance'] _required: true index: 94 min: 1 emptyReason: {mustSupport: false, index: 95} section: {mustSupport: false, index: 96} required: [entry, text, title, code] sectionProblems: match: code: coding: - {code: 11450-4, system: 'http://loinc.org'} schema: short: PS-ON Problems Section mustSupport: true _required: true index: 97 elements: title: {mustSupport: true, index: 98} code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 11450-4, system: 'http://loinc.org'} index: 99 text: {mustSupport: true, index: 100} entry: short: Clinical problems or conditions currently being monitored for the patient. mustSupport: true index: 101 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: problem: match: {} schema: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-condition'] _required: true index: 102 min: 1 emptyReason: {mustSupport: false, index: 103} section: {mustSupport: false, index: 104} required: [entry, text, title, code] sectionProceduresHx: match: code: coding: - {code: 47519-4, system: 'http://loinc.org'} schema: short: PS-ON History of Procedures Section mustSupport: true index: 105 elements: title: {mustSupport: true, index: 106} code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 47519-4, system: 'http://loinc.org'} index: 107 text: {mustSupport: true, index: 108} entry: short: Patient past procedures pertinent to the scope of this document. mustSupport: true index: 109 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: procedure: match: {} schema: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-procedure'] _required: true index: 110 min: 1 emptyReason: {mustSupport: false, index: 111} section: {mustSupport: false, index: 112} required: [entry, text, title, code] sectionImmunizations: match: code: coding: - {code: 11369-6, system: 'http://loinc.org'} schema: short: PS-ON Immunizations Section mustSupport: true index: 113 elements: title: {mustSupport: true, index: 114} code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 11369-6, system: 'http://loinc.org'} index: 115 text: {mustSupport: true, index: 116} entry: short: Patient's immunization status and pertinent history. mustSupport: true index: 117 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: immunization: match: {} schema: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-immunization'] _required: true index: 118 min: 1 emptyReason: {mustSupport: false, index: 119} section: {mustSupport: false, index: 120} required: [entry, text, title, code] sectionPastIllnessHx: match: code: coding: - {code: 11348-0, system: 'http://loinc.org'} schema: short: PS-CA History of Past Illness Section mustSupport: true index: 121 elements: title: {mustSupport: true, index: 122} code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 11348-0, system: 'http://loinc.org'} index: 123 text: {mustSupport: true, index: 124} entry: short: Conditions the patient suffered in the past. mustSupport: true index: 125 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: pastProblem: match: {} schema: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-condition'] _required: true index: 126 min: 1 emptyReason: {mustSupport: false, index: 127} section: {mustSupport: false, index: 128} required: [entry, text, title, code] attester: mustSupport: true index: 66 elements: mode: {mustSupport: true, index: 67} time: {mustSupport: true, index: 68} party: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole'] index: 69 required: [party] type: short: Kind of composition ("Patient Summary") mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 60591-5, system: 'http://loinc.org'} index: 7 title: {short: Ontario Patient Summary, mustSupport: true, index: 65} author: short: Who and/or what authored the patient summary mustSupport: true index: 62 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: PractitionerRolePSON: match: {} schema: type: Reference short: Who and/or what authored the patient summary mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole'] index: 63 DevicePSON: match: {} schema: type: Reference short: Who and/or what authored the patient summary mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-device'] index: 64 event: index: 71 slicing: rules: open discriminator: - {path: code, type: pattern} min: null slices: careProvisioningEvent: match: code: coding: - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'} schema: short: The care provisioning being documented index: 72 elements: code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'} index: 73 elements: coding: index: 74 elements: system: pattern: {type: Uri, value: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'} index: 75 code: pattern: {type: Code, value: PCPR} index: 76 required: [system, code] required: [coding] period: {mustSupport: true, index: 77} required: [code] custodian: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-organization'] index: 70 status: {mustSupport: true, index: 6} identifier: mustSupport: true index: 3 elements: system: {mustSupport: true, index: 4} value: {mustSupport: true, index: 5} required: [value, system] subject: type: Reference mustSupport: true refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient'] index: 58 elements: reference: {mustSupport: true, index: 59} required: [reference] text: {mustSupport: true, index: 2} package_version: 0.11.0 class: profile kind: resource url: http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-composition base: http://hl7.org/fhir/StructureDefinition/Composition version: 0.11.0 required: [attester, section, identifier, subject, meta, custodian]