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:
  date: {mustSupport: true, index: 10}
  meta:
    mustSupport: true
    index: 1
    elements:
      profile: {mustSupport: true, index: 2}
    required: [profile]
  encounter: {index: 9}
  section:
    short: Sections composing the PS
    mustSupport: true
    index: 33
    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: 34
            elements:
              title: {short: Medication Summary section, mustSupport: true, index: 35}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 10160-0, system: 'http://loinc.org'}
                index: 36
              text: {type: Narrative, mustSupport: true, index: 37}
              entry:
                short: Medications relevant for the scope of the patient summary
                mustSupport: true
                index: 38
                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: 39
                      min: 1
              emptyReason: {mustSupport: false, index: 40}
              section: {mustSupport: false, index: 41}
            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: 42
            elements:
              title: {mustSupport: true, index: 43}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 48765-2, system: 'http://loinc.org'}
                index: 44
              text: {type: Narrative, mustSupport: true, index: 45}
              entry:
                short: Relevant allergies or intolerances (conditions) for that patient.
                mustSupport: true
                index: 46
                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: 47
                      min: 1
              emptyReason: {mustSupport: false, index: 48}
              section: {mustSupport: false, index: 49}
            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: 50
            elements:
              title: {mustSupport: true, index: 51}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11450-4, system: 'http://loinc.org'}
                index: 52
              text: {type: Narrative, mustSupport: true, index: 53}
              entry:
                short: Clinical problems or conditions currently being monitored for the patient.
                mustSupport: true
                index: 54
                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: 55
                      min: 1
              emptyReason: {mustSupport: false, index: 56}
              section: {mustSupport: false, index: 57}
            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: 58
            elements:
              title: {mustSupport: true, index: 59}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 47519-4, system: 'http://loinc.org'}
                index: 60
              text: {type: Narrative, mustSupport: true, index: 61}
              entry:
                short: Patient past procedures pertinent to the scope of this document.
                mustSupport: true
                index: 62
                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: 63
                      min: 1
              emptyReason: {mustSupport: false, index: 64}
              section: {mustSupport: false, index: 65}
            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: 66
            elements:
              title: {mustSupport: true, index: 67}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11369-6, system: 'http://loinc.org'}
                index: 68
              text: {type: Narrative, mustSupport: true, index: 69}
              entry:
                short: Patient's immunization status and pertinent history.
                mustSupport: true
                index: 70
                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: 71
                      min: 1
              emptyReason: {mustSupport: false, index: 72}
              section: {mustSupport: false, index: 73}
            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: 74
            elements:
              title: {mustSupport: true, index: 75}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11348-0, system: 'http://loinc.org'}
                index: 76
              text: {mustSupport: true, index: 77}
              entry:
                short: Conditions the patient suffered in the past.
                mustSupport: true
                index: 78
                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: 79
                      min: 1
              emptyReason: {mustSupport: false, index: 80}
              section: {mustSupport: false, index: 81}
            required: [entry, text, title, code]
  attester:
    mustSupport: true
    index: 16
    elements:
      mode: {mustSupport: true, index: 17}
      time: {mustSupport: true, index: 18}
      party:
        type: Reference
        mustSupport: true
        refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole']
        index: 19
    required: [party]
  type:
    short: Kind of composition ("Patient Summary")
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 60591-5, system: 'http://loinc.org'}
    index: 6
  title: {short: Ontario Patient Summary, mustSupport: true, index: 14}
  author:
    short: Who and/or what authored the patient summary
    mustSupport: true
    index: 11
    slicing:
      rules: open
      discriminator:
      - {path: resolve(), type: profile}
      min: null
      slices:
        PractitionerRolePSON:
          match: {}
          schema:
            short: Who and/or what authored the patient summary
            refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole']
            type: Reference
            mustSupport: true
            index: 12
          min: 0
        DevicePSON:
          match: {}
          schema:
            short: Who and/or what authored the patient summary
            refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-device']
            type: Reference
            mustSupport: true
            index: 13
          min: 0
  event:
    mustSupport: true
    index: 25
    elements:
      code:
        binding: {strength: preferred, valueSet: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
        index: 26
    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
            mustSupport: true
            index: 27
            elements:
              code:
                binding: {strength: preferred, valueSet: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
                index: 28
                elements:
                  coding:
                    index: 29
                    elements:
                      system:
                        pattern: {type: Code, value: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
                        index: 30
                      code:
                        pattern: {type: Code, value: PCPR}
                        index: 31
                    required: [system, code]
                required: [coding]
              period: {mustSupport: true, index: 32}
            required: [code]
  custodian:
    type: Reference
    mustSupport: true
    refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-organization']
    index: 20
  status: {mustSupport: true, index: 5}
  id: {index: 0}
  identifier: {mustSupport: true, index: 4}
  relatesTo:
    mustSupport: true
    index: 21
    elements:
      code: {mustSupport: true, index: 22}
      target:
        mustSupport: true
        choices: []
        index: 24
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient']
    index: 7
    elements:
      reference: {mustSupport: true, index: 8}
    required: [reference]
  confidentiality: {mustSupport: true, index: 15}
  text: {mustSupport: true, index: 3}
package_version: 0.10.0-alpha-1
class: profile
kind: resource
url: http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-composition
base: http://hl7.org/fhir/StructureDefinition/Composition
version: 0.9.1
required: [attester, section, identifier, type, meta, custodian]