{
  "description": "Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions.",
  "_filename": "StructureDefinition-ChangeMade.json",
  "package_name": "hl7.fhir.uv.fhir-clinical-document",
  "date": "2025-06-26T21:24:20+00:00",
  "derivation": "constraint",
  "publisher": "HL7 International / Structured Documents",
  "fhirVersion": "4.0.1",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "name": "ChangeMade",
  "mapping": [ {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  } ],
  "abstract": false,
  "copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
  "type": "Extension",
  "experimental": "true",
  "resourceType": "StructureDefinition",
  "title": "Change Made",
  "package_version": "1.0.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "sd"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "informative",
    "_valueCode": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "http://hl7.org/fhir/uv/fhir-clinical-document/ImplementationGuide/hl7.fhir.uv.fhir-clinical-document"
      } ]
    }
  } ],
  "snapshot": {
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        "key": "ele-1",
        "human": "All FHIR elements must have a @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": "Extension",
      "min": 0,
      "definition": "Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions.",
      "isModifier": false,
      "short": "Change Made",
      "max": "*",
      "id": "Extension",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Extension"
      }
    }, {
      "path": "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": "Extension.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": "Extension.extension",
      "min": 2,
      "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"
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      "max": "*",
      "id": "Extension.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": "Extension.extension",
      "min": 1,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Annotation of a change.",
      "type": [ {
        "code": "Extension"
      } ],
      "sliceName": "change",
      "max": "1",
      "id": "Extension.extension:change",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Extension.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": "Extension.extension:change.id",
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        "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": "Extension.extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
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        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Extension.extension:change.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Extension.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": "change",
      "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": "Extension.extension:change.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": "Extension.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": "Annotation"
      } ],
      "max": "1",
      "id": "Extension.extension:change.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": "Extension.extension",
      "min": 1,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Version of Document Bundle produced by preceeding version of Compsition. This points to the Document Bundle and not the Composition, as the Document Bundle represents a static document. Intermediate versioning changes to Composition are expected to be handled in a different manner.",
      "type": [ {
        "code": "Extension"
      } ],
      "sliceName": "version-changed",
      "max": "1",
      "id": "Extension.extension:version-changed",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Extension.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": "Extension.extension:version-changed.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": "Extension.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": "Extension.extension:version-changed.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Extension.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": "version-changed",
      "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": "Extension.extension:version-changed.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": "Extension.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/Bundle" ]
      } ],
      "max": "1",
      "id": "Extension.extension:version-changed.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "path": "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/uv/fhir-clinical-document/StructureDefinition/ChangeMade",
      "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": "Extension.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())"
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      "path": "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"
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      "type": [ {
        "code": "base64Binary"
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        "code": "boolean"
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        "code": "canonical"
      }, {
        "code": "code"
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        "code": "date"
      }, {
        "code": "dateTime"
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        "code": "decimal"
      }, {
        "code": "id"
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        "code": "instant"
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      }, {
        "code": "oid"
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        "code": "positiveInt"
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      }, {
        "code": "time"
      }, {
        "code": "unsignedInt"
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        "code": "uri"
      }, {
        "code": "url"
      }, {
        "code": "uuid"
      }, {
        "code": "Address"
      }, {
        "code": "Age"
      }, {
        "code": "Annotation"
      }, {
        "code": "Attachment"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "Coding"
      }, {
        "code": "ContactPoint"
      }, {
        "code": "Count"
      }, {
        "code": "Distance"
      }, {
        "code": "Duration"
      }, {
        "code": "HumanName"
      }, {
        "code": "Identifier"
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        "code": "Money"
      }, {
        "code": "Period"
      }, {
        "code": "Quantity"
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        "code": "Range"
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        "code": "Ratio"
      }, {
        "code": "Reference"
      }, {
        "code": "SampledData"
      }, {
        "code": "Signature"
      }, {
        "code": "Timing"
      }, {
        "code": "ContactDetail"
      }, {
        "code": "Contributor"
      }, {
        "code": "DataRequirement"
      }, {
        "code": "Expression"
      }, {
        "code": "ParameterDefinition"
      }, {
        "code": "RelatedArtifact"
      }, {
        "code": "TriggerDefinition"
      }, {
        "code": "UsageContext"
      }, {
        "code": "Dosage"
      }, {
        "code": "Meta"
      } ],
      "max": "0",
      "id": "Extension.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
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      "isSummary": false
    } ],
    "extension": [ {
      "url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
      "valueString": "4.0.1"
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  },
  "status": "active",
  "id": "b5e8ccac-c049-4467-8772-6cef91d9fa95",
  "kind": "complex-type",
  "url": "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade",
  "context": [ {
    "type": "element",
    "expression": "Composition"
  } ],
  "version": "1.0.0",
  "differential": {
    "element": [ {
      "id": "Extension",
      "path": "Extension",
      "short": "Change Made",
      "definition": "Change Made provides an annotation of a change that has been made to the Composition or Composition section. The extension is experimental and may overlap with other extensions, such as use of note in R6. The extension contains two parts: change - the description of the change, version-changed - the FHIR Clinical Document version that was changed. Note: Calculating a differential between versions is suggested for safely finding all changes as this annotation may not contain all changes between versions."
    }, {
      "id": "Extension.extension",
      "min": 2,
      "path": "Extension.extension"
    }, {
      "id": "Extension.extension:change",
      "max": "1",
      "min": 1,
      "path": "Extension.extension",
      "short": "Annotation of a change.",
      "sliceName": "change"
    }, {
      "id": "Extension.extension:change.extension",
      "max": "0",
      "path": "Extension.extension.extension"
    }, {
      "id": "Extension.extension:change.url",
      "path": "Extension.extension.url",
      "fixedUri": "change"
    }, {
      "id": "Extension.extension:change.value[x]",
      "min": 1,
      "path": "Extension.extension.value[x]",
      "type": [ {
        "code": "Annotation"
      } ]
    }, {
      "id": "Extension.extension:version-changed",
      "max": "1",
      "min": 1,
      "path": "Extension.extension",
      "short": "Version of Document Bundle produced by preceeding version of Compsition. This points to the Document Bundle and not the Composition, as the Document Bundle represents a static document. Intermediate versioning changes to Composition are expected to be handled in a different manner.",
      "sliceName": "version-changed"
    }, {
      "id": "Extension.extension:version-changed.extension",
      "max": "0",
      "path": "Extension.extension.extension"
    }, {
      "id": "Extension.extension:version-changed.url",
      "path": "Extension.extension.url",
      "fixedUri": "version-changed"
    }, {
      "id": "Extension.extension:version-changed.value[x]",
      "min": 1,
      "path": "Extension.extension.value[x]",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Bundle" ]
      } ]
    }, {
      "id": "Extension.url",
      "path": "Extension.url",
      "fixedUri": "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/ChangeMade"
    }, {
      "id": "Extension.value[x]",
      "max": "0",
      "path": "Extension.value[x]"
    } ]
  },
  "contact": [ {
    "name": "HL7 International / Structured Documents",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/structure",
      "system": "url"
    }, {
      "value": "strucdoc@lists.hl7.org",
      "system": "email"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension"
}