{
"description": "Base StructureDefinition for Composition Resource",
"_filename": "Composition.json",
"package_name": "BCPatientSummary.Draft",
"date": "2017-04-19T07:44:43+10:00",
"derivation": "specialization",
"meta": {
"lastUpdated": "2018-05-03T22:08:01.813+00:00"
},
"publisher": "Health Level Seven International (Structured Documents)",
"fhirVersion": "3.0.1",
"purpose": "To support documents, and also to capture the EN13606 notion of an attested commit to the patient EHR, and to allow a set of disparate resources at the information/engineering level to be gathered into a clinical statement.",
"name": "Composition",
"mapping": [ {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/v3/cda",
"name": "CDA (R2)",
"identity": "cda"
}, {
"uri": "http://hl7.org/fhir/w5",
"name": "W5 Mapping",
"identity": "w5"
} ],
"abstract": false,
"type": "Composition",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "0.0.1-draft",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "sd"
} ],
"status": "draft",
"id": "bcd1671e-deab-4223-89f6-59ba2e986187",
"kind": "resource",
"url": "http://hl7.org/fhir/StructureDefinition/Composition",
"version": null,
"differential": {
"element": [ {
"id": "Composition",
"path": "Composition",
"short": "A set of resources composed into a single coherent clinical statement with clinical attestation",
"comment": "While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.",
"mapping": [ {
"map": "Document[classCode=\"DOC\" and moodCode=\"EVN\" and isNormalAct()]",
"identity": "rim"
}, {
"map": "ClinicalDocument",
"identity": "cda"
}, {
"map": "infrastructure.documents",
"identity": "w5"
} ],
"definition": "A set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained."
}, {
"path": "Composition.identifier",
"definition": "Logical identifier for the composition, assigned when created. This identifier stays constant as the composition is changed over time.",
"short": "Logical identifier of composition (version-independent)",
"mapping": [ {
"map": "Document.id / Document.setId",
"identity": "rim"
}, {
"map": ".setId",
"identity": "cda"
}, {
"map": "id",
"identity": "w5"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "Composition.identifier",
"comment": "See discussion in resource definition for how these relate.",
"isSummary": true
}, {
"path": "Composition.status",
"requirements": "Need to be able to mark interim, amended, or withdrawn compositions or documents.",
"min": 1,
"definition": "The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.",
"isModifier": true,
"short": "preliminary | final | amended | entered-in-error",
"mapping": [ {
"map": "interim: .completionCode=\"IN\" & ./statusCode[isNormalDatatype()]=\"active\"; final: .completionCode=\"AU\" && ./statusCode[isNormalDatatype()]=\"complete\" and not(./inboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()]/source[subsumesCode(\"ActClass#CACT\") and moodCode=\"EVN\" and domainMember(\"ReviseComposition\", code) and isNormalAct()]); amended: .completionCode=\"AU\" && ./statusCode[isNormalDatatype()]=\"complete\" and ./inboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()]/source[subsumesCode(\"ActClass#CACT\") and moodCode=\"EVN\" and domainMember(\"ReviseComposition\", code) and isNormalAct() and statusCode=\"completed\"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]=\"obsolete\"",
"identity": "rim"
}, {
"map": "n/a",
"identity": "cda"
}, {
"map": "status",
"identity": "w5"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionStatus"
} ],
"description": "The workflow/clinical status of the composition.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/composition-status"
}
},
"max": "1",
"id": "Composition.status",
"comment": "If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag \"entered-in-error\" is why this element is labeled as a modifier of other elements. \n\nSome reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.",
"isSummary": true
}, {
"path": "Composition.type",
"requirements": "Key metadata element describing the composition, used in searching/filtering.",
"min": 1,
"definition": "Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.",
"short": "Kind of composition (LOINC if possible)",
"mapping": [ {
"map": "./code",
"identity": "rim"
}, {
"map": ".code",
"identity": "cda"
}, {
"map": "class",
"identity": "w5"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentType"
} ],
"description": "Type of a composition.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/doc-typecodes"
}
},
"max": "1",
"id": "Composition.type",
"comment": "For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.",
"isSummary": true
}, {
"path": "Composition.class",
"requirements": "Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.",
"definition": "A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.",
"short": "Categorization of Composition",
"mapping": [ {
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code",
"identity": "rim"
}, {
"map": "n/a",
"identity": "cda"
}, {
"map": "class",
"identity": "w5"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentClass"
} ],
"description": "High-level kind of a clinical document at a macro level.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/doc-classcodes"
}
},
"max": "1",
"id": "Composition.class",
"comment": "This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)).",
"isSummary": true
}, {
"path": "Composition.subject",
"requirements": "Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.",
"min": 1,
"definition": "Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).",
"short": "Who and/or what the composition is about",
"mapping": [ {
"map": ".participation[typeCode=\"SBJ\"].role[typeCode=\"PAT\"]",
"identity": "rim"
}, {
"map": ".recordTarget",
"identity": "cda"
}, {
"map": "who.focus",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
} ],
"max": "1",
"id": "Composition.subject",
"comment": "For clinical documents, this is usually the patient.",
"isSummary": true
}, {
"path": "Composition.encounter",
"requirements": "Provides context for the composition and supports searching.",
"definition": "Describes the clinical encounter or type of care this documentation is associated with.",
"short": "Context of the Composition",
"mapping": [ {
"map": "unique(highest(./outboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()], priorityNumber)/target[moodCode=\"EVN\" and classCode=(\"ENC\", \"PCPR\") and isNormalAct])",
"identity": "rim"
}, {
"map": ".componentOf.encompassingEncounter",
"identity": "cda"
}, {
"map": "context",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
} ],
"max": "1",
"id": "Composition.encounter",
"isSummary": true
}, {
"path": "Composition.date",
"requirements": "dateTime is used for tracking, organizing versions and searching.",
"min": 1,
"definition": "The composition editing time, when the composition was last logically changed by the author.",
"short": "Composition editing time",
"mapping": [ {
"map": ".effectiveTime[type=\"TS\"]",
"identity": "rim"
}, {
"map": ".effectiveTime",
"identity": "cda"
}, {
"map": "when.done",
"identity": "w5"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "Composition.date",
"comment": "The Last Modified Date on the composition may be after the date of the document was attested without being changed.",
"isSummary": true
}, {
"path": "Composition.author",
"requirements": "Identifies who is responsible for the content.",
"min": 1,
"definition": "Identifies who is responsible for the information in the composition, not necessarily who typed it in.",
"short": "Who and/or what authored the composition",
"mapping": [ {
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]",
"identity": "rim"
}, {
"map": ".author.assignedAuthor",
"identity": "cda"
}, {
"map": "who.author",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
} ],
"id": "Composition.author",
"isSummary": true
}, {
"path": "Composition.title",
"min": 1,
"definition": "Official human-readable label for the composition.",
"short": "Human Readable name/title",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "Composition.title",
"comment": "For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a \"consultation\" or \"progress note\"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.",
"isSummary": true
}, {
"path": "Composition.confidentiality",
"definition": "The code specifying the level of confidentiality of the Composition.",
"isModifier": true,
"short": "As defined by affinity domain",
"mapping": [ {
"map": ".confidentialityCode",
"identity": "rim"
}, {
"map": ".confidentialityCode",
"identity": "cda"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentConfidentiality"
} ],
"description": "Codes specifying the level of confidentiality of the composition.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/v3-ConfidentialityClassification"
}
},
"max": "1",
"id": "Composition.confidentiality",
"comment": "The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section).\n\nThis element is labeled as a modifier because highly confidential documents must not be treated as if they are not.",
"isSummary": true
}, {
"path": "Composition.attester",
"requirements": "Identifies responsibility for the accuracy of the composition content.",
"definition": "A participant who has attested to the accuracy of the composition/document.",
"short": "Attests to accuracy of composition",
"mapping": [ {
"map": ".participation[typeCode=\"AUTHEN\"].role[classCode=\"ASSIGNED\"]",
"identity": "rim"
}, {
"map": ".authenticator/.legalAuthenticator",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"id": "Composition.attester",
"comment": "Only list each attester once.",
"isSummary": true
}, {
"path": "Composition.attester.mode",
"requirements": "Indicates the level of authority of the attestation.",
"min": 1,
"definition": "The type of attestation the authenticator offers.",
"short": "personal | professional | legal | official",
"mapping": [ {
"map": "unique(./modeCode)",
"identity": "rim"
}, {
"map": "implied by .authenticator/.legalAuthenticator",
"identity": "cda"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionAttestationMode"
} ],
"description": "The way in which a person authenticated a composition.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/composition-attestation-mode"
}
},
"id": "Composition.attester.mode",
"comment": "Use more than one code where a single attester has more than one mode (professional and legal are often paired).",
"isSummary": true
}, {
"path": "Composition.attester.time",
"requirements": "Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).",
"definition": "When the composition was attested by the party.",
"short": "When the composition was attested",
"mapping": [ {
"map": "./time[type=\"TS\" and isNormalDatatype()]",
"identity": "rim"
}, {
"map": ".authenticator.time",
"identity": "cda"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "Composition.attester.time",
"isSummary": true
}, {
"path": "Composition.attester.party",
"requirements": "Identifies who has taken on the responsibility for accuracy of the composition content.",
"definition": "Who attested the composition in the specified way.",
"short": "Who attested the composition",
"mapping": [ {
"map": "./role[classCode=\"ASSIGNED\" and isNormalRole]/player[determinerCode=\"INST\" and classCode=(\"DEV\", \"PSN\") and isNormalEntity()] or ./role[classCode=\"ASSIGNED\" and isNormalRole and not(player)]/scoper[determinerCode=\"INST\" and classCode=\"ORG\" and isNormalEntity()]",
"identity": "rim"
}, {
"map": ".authenticator.assignedEnttty",
"identity": "cda"
}, {
"map": "who.witness",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
} ],
"max": "1",
"id": "Composition.attester.party",
"isSummary": true
}, {
"path": "Composition.custodian",
"requirements": "Identifies where to go to find the current version, where to report issues, etc.",
"definition": "Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.",
"short": "Organization which maintains the composition",
"mapping": [ {
"map": ".participation[typeCode=\"RCV\"].role[classCode=\"CUST\"].scoper[classCode=\"ORG\" and determinerCode=\"INST\"]",
"identity": "rim"
}, {
"map": ".custodian.assignedCustodian",
"identity": "cda"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
} ],
"max": "1",
"id": "Composition.custodian",
"comment": "This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.",
"isSummary": true
}, {
"id": "Composition.relatesTo",
"path": "Composition.relatesTo",
"type": [ {
"code": "BackboneElement"
} ],
"short": "Relationships to other compositions/documents",
"comment": "A document is a version specific composition.",
"mapping": [ {
"map": ".outboundRelationship",
"identity": "rim"
}, {
"map": ".relatedDocument",
"identity": "cda"
} ],
"isSummary": true,
"definition": "Relationships that this composition has with other compositions or documents that already exist."
}, {
"path": "Composition.relatesTo.code",
"min": 1,
"definition": "The type of relationship that this composition has with anther composition or document.",
"short": "replaces | transforms | signs | appends",
"mapping": [ {
"map": ".outboundRelationship.typeCode",
"identity": "rim"
}, {
"map": ".relatedDocument.typeCode",
"identity": "cda"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentRelationshipType"
} ],
"description": "The type of relationship between documents.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/document-relationship-type"
}
},
"max": "1",
"id": "Composition.relatesTo.code",
"comment": "If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.",
"isSummary": true
}, {
"path": "Composition.relatesTo.target[x]",
"min": 1,
"definition": "The target composition/document of this relationship.",
"short": "Target of the relationship",
"mapping": [ {
"map": ".target[classCode=\"DOC\", moodCode=\"EVN\"].id",
"identity": "rim"
}, {
"map": ".relatedDocument.id",
"identity": "cda"
} ],
"type": [ {
"code": "Identifier"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Composition"
} ],
"max": "1",
"id": "Composition.relatesTo.target[x]",
"isSummary": true
}, {
"path": "Composition.event",
"requirements": "Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.",
"definition": "The clinical service, such as a colonoscopy or an appendectomy, being documented.",
"short": "The clinical service(s) being documented",
"mapping": [ {
"map": "outboundRelationship[typeCode=\"SUBJ\"].target[classCode<'ACT']",
"identity": "rim"
}, {
"map": ".documentationOf.serviceEvent",
"identity": "cda"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"id": "Composition.event",
"comment": "The event needs to be consistent with the type element, though can provide further information if desired.",
"isSummary": true
}, {
"path": "Composition.event.code",
"definition": "This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a \"History and Physical Report\" in which the procedure being documented is necessarily a \"History and Physical\" act.",
"short": "Code(s) that apply to the event being documented",
"mapping": [ {
"map": ".code",
"identity": "rim"
}, {
"map": ".code",
"identity": "cda"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentEventType"
} ],
"description": "This list of codes represents the main clinical acts being documented.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/v3-ActCode"
}
},
"id": "Composition.event.code",
"comment": "An event can further specialize the act inherent in the typeCode, such as where it is simply \"Procedure Report\" and the procedure was a \"colonoscopy\". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.",
"isSummary": true
}, {
"id": "Composition.event.period",
"max": "1",
"path": "Composition.event.period",
"type": [ {
"code": "Period"
} ],
"short": "The period covered by the documentation",
"mapping": [ {
"map": ".effectiveTime",
"identity": "rim"
}, {
"map": ".effectiveTime",
"identity": "cda"
} ],
"isSummary": true,
"definition": "The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time."
}, {
"id": "Composition.event.detail",
"path": "Composition.event.detail",
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
} ],
"short": "The event(s) being documented",
"mapping": [ {
"map": ".outboundRelationship[typeCode=\"SUBJ\"].target",
"identity": "rim"
}, {
"map": "n/a",
"identity": "cda"
} ],
"isSummary": true,
"definition": "The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy."
}, {
"id": "Composition.section",
"path": "Composition.section",
"type": [ {
"code": "BackboneElement"
} ],
"short": "Composition is broken into sections",
"mapping": [ {
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]",
"identity": "rim"
}, {
"map": ".component.structuredBody.component.section",
"identity": "cda"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
} ],
"constraint": [ {
"key": "cmp-1",
"human": "A section must at least one of text, entries, or sub-sections",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)",
"severity": "error",
"expression": "text.exists() or entry.exists() or section.exists()"
}, {
"key": "cmp-2",
"human": "A section can only have an emptyReason if it is empty",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))",
"severity": "error",
"expression": "emptyReason.empty() or entry.empty()"
} ],
"definition": "The root of the sections that make up the composition."
}, {
"path": "Composition.section.title",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"short": "Label for section (e.g. for ToC)",
"mapping": [ {
"map": "./title",
"identity": "rim"
}, {
"map": ".title",
"identity": "cda"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "header", "label", "caption" ],
"max": "1",
"id": "Composition.section.title",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element."
}, {
"path": "Composition.section.code",
"requirements": "Provides computable standardized labels to topics within the document.",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"short": "Classification of section (recommended)",
"mapping": [ {
"map": "./code",
"identity": "rim"
}, {
"map": ".code",
"identity": "cda"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
} ],
"description": "Classification of a section of a composition/document.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/doc-section-codes"
}
},
"max": "1",
"id": "Composition.section.code",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code."
}, {
"path": "Composition.section.text",
"definition": "A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative.",
"short": "Text summary of the section, for human interpretation",
"mapping": [ {
"map": ".text",
"identity": "rim"
}, {
"map": ".text",
"identity": "cda"
} ],
"type": [ {
"code": "Narrative"
} ],
"max": "1",
"id": "Composition.section.text",
"condition": [ "cmp-1" ],
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety."
}, {
"path": "Composition.section.mode",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"isModifier": true,
"short": "working | snapshot | changes",
"mapping": [ {
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value",
"identity": "rim"
}, {
"map": "n/a",
"identity": "cda"
}, {
"map": "class",
"identity": "w5"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
} ],
"description": "The processing mode that applies to this section.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/list-mode"
}
},
"max": "1",
"id": "Composition.section.mode",
"comment": "This element is labeled as a modifier because a change list must not be mis-understood as a complete list.",
"isSummary": true
}, {
"path": "Composition.section.orderedBy",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"definition": "Specifies the order applied to the items in the section entries.",
"short": "Order of section entries",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1",
"identity": "rim"
}, {
"map": "n/a",
"identity": "cda"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
} ],
"description": "What order applies to the items in the entry.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/list-order"
}
},
"max": "1",
"id": "Composition.section.orderedBy",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order."
}, {
"id": "Composition.section.entry",
"path": "Composition.section.entry",
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
} ],
"short": "A reference to data that supports this section",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": ".entry",
"identity": "cda"
} ],
"condition": [ "cmp-2" ],
"definition": "A reference to the actual resource from which the narrative in the section is derived."
}, {
"path": "Composition.section.emptyReason",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"short": "Why the section is empty",
"mapping": [ {
"map": ".inboundRelationship[typeCode=SUBJ,code<{ListEmptyReason}].value[type=CD]",
"identity": "rim"
}, {
"map": "n/a",
"identity": "cda"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
} ],
"description": "If a section is empty, why it is empty.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/list-empty-reason"
}
},
"max": "1",
"id": "Composition.section.emptyReason",
"condition": [ "cmp-2" ],
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases."
} ]
},
"contact": [ {
"telecom": [ {
"value": "http://hl7.org/fhir",
"system": "url"
} ]
}, {
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/structure/index.cfm",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}