description: 'This Composition profile represents an electronic initial case report (eICR). It describes the content requirements for the eICR including:         \n\n* patient demographics         \n* patient pregnancy status         \n* patient occupation and travel history         \n* provider and facility information         \n* laboratory orders, tests, and results         \n* signs, symptoms, and diagnoses\n* medication and immunization information\n* flags for the existence of reportable condition trigger codes in diagnoses, ordered/resulted laboratory tests, medications, and immunizations\n    * flags contain RCTC OID and RCTC version\n* codes indicating whether the eICR was manually or alternately initiated'
package_name: hl7.fhir.us.ecr
derivation: constraint
name: Eicr_Composition
type: Composition
elements:
  category:
    short: Manual/Alternate Initiation
    binding: {strength: extensible, valueSet: 'https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.11'}
    mustSupport: true
    index: 6
  date: {isModifier: false, mustSupport: true, index: 9}
  encounter:
    isModifier: false
    short: Encounter related to the eICR event
    refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-encounter']
    type: Reference
    mustSupport: true
    index: 8
  section:
    index: 21
    slicing:
      rules: open
      discriminator:
      - {path: code, type: value}
      min: null
      slices:
        sliceHistoryOfPresentIllnessSection:
          match:
            code:
              coding:
              - {code: 10164-2, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: History of Present Illness Section
            mustSupport: true
            _required: true
            index: 25
            elements:
              code:
                isModifier: false
                short: History of Present Illness code
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 10164-2, system: 'http://loinc.org'}
                index: 26
              text: {short: History of Present Illness narrative, mustSupport: true, index: 27}
            required: [text, code]
        sliceMedicationsAdministeredSection:
          match:
            code:
              coding:
              - {code: 29549-3, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Medications Administered Section
            mustSupport: true
            _required: true
            index: 35
            elements:
              code:
                isModifier: false
                short: Medications Administered Section code
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 29549-3, system: 'http://loinc.org'}
                index: 36
              text: {short: Medications Administered Section narrative, mustSupport: true, index: 37}
              entry:
                mustSupport: true
                index: 38
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceMedicationAdministration:
                      match: {}
                      schema:
                        isModifier: false
                        short: Medication Administration entry
                        refers: ['http://hl7.org/fhir/StructureDefinition/MedicationAdministration']
                        type: Reference
                        mustSupport: true
                        index: 39
                        extensions:
                          sliceTriggerMedicationAdministered: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', max: 1, type: Extension, short: eICR Trigger Code Flag, index: 41}
                        elements:
                          extension:
                            index: 40
                            slicing:
                              rules: open
                              discriminator:
                              - {path: url, type: value}
                              min: null
                              slices:
                                sliceTriggerMedicationAdministered:
                                  match: {url: null}
                                  schema: {type: Extension, short: eICR Trigger Code Flag, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', index: 41}
                                  max: 1
            required: [text, code]
        sliceVitalSignsSection:
          match:
            code:
              coding:
              - {code: 8716-3, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Vital Signs Section
            mustSupport: true
            index: 66
            elements:
              code:
                short: Vital Signs
                isModifier: false
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 8716-3, system: 'http://loinc.org'}
                index: 67
              text: {mustSupport: true, index: 68}
              entry:
                mustSupport: true
                index: 69
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceVitalSigns:
                      match: {}
                      schema:
                        type: Reference
                        isModifier: false
                        mustSupport: true
                        refers: ['http://hl7.org/fhir/StructureDefinition/vitalsigns']
                        index: 70
            required: [text, code]
        sliceReasonForVisitSection:
          match:
            code:
              coding:
              - {code: 29299-5, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Reason for Visit Section
            mustSupport: true
            _required: true
            index: 22
            elements:
              code:
                isModifier: false
                short: Reason for Visit code
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 29299-5, system: 'http://loinc.org'}
                index: 23
              text: {short: Reason for Visit narrative, mustSupport: true, index: 24}
            required: [text, code]
        slicePregnancySection:
          match:
            code:
              coding:
              - {code: 90767-5, system: 'http://loinc.org'}
          schema:
            short: Pregnancy Section
            mustSupport: true
            index: 79
            elements:
              code:
                short: Pregnancy summary Document
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 90767-5, system: 'http://loinc.org'}
                index: 80
              text: {mustSupport: true, index: 81}
              entry:
                index: 82
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    slicePregnancyStatusObservation:
                      match: {}
                      schema:
                        min: 1
                        short: Pregnancy Status Observation entry
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/pregnancy-status-observation']
                        type: Reference
                        array: true
                        _required: true
                        index: 83
                      min: 1
                    slicePregnancyOutcome:
                      match: {}
                      schema:
                        type: Reference
                        short: Pregnancy Outcome entry
                        mustSupport: true
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/pregnancy-outcome-observation']
                        index: 84
                    sliceLastMenstrualPeriod:
                      match: {}
                      schema:
                        type: Reference
                        short: Last Menstrual Period entry
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/last-menstrual-period']
                        index: 85
                    slicePostpartumStatus:
                      match: {}
                      schema:
                        type: Reference
                        short: Postpartum Status entry
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/postpartum-status']
                        index: 86
            required: [text, code]
        sliceImmunizationsSection:
          match:
            code:
              coding:
              - {code: 11369-6, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Immunizations Section
            mustSupport: true
            index: 59
            elements:
              code:
                short: Immunizations
                isModifier: false
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11369-6, system: 'http://loinc.org'}
                index: 60
              text: {mustSupport: true, index: 61}
              entry:
                mustSupport: true
                index: 62
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceUSCoreImmunization:
                      match: {}
                      schema:
                        isModifier: false
                        short: Immunization entry
                        refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization']
                        type: Reference
                        mustSupport: true
                        index: 63
                        extensions:
                          sliceTriggerImmunization: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', type: Extension, short: eICR Trigger Code Flag, index: 65}
                        elements:
                          extension:
                            index: 64
                            slicing:
                              rules: open
                              discriminator:
                              - {path: url, type: value}
                              min: null
                              slices:
                                sliceTriggerImmunization:
                                  match: {url: null}
                                  schema: {type: Extension, short: eICR Trigger Code Flag, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', index: 65}
            required: [text, code]
        sliceResultsSection:
          match:
            code:
              coding:
              - {code: 30954-2, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Results Section
            mustSupport: true
            _required: true
            index: 42
            elements:
              code:
                isModifier: false
                short: Results Section code
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 30954-2, system: 'http://loinc.org'}
                index: 43
              text: {short: Results Section narrative, mustSupport: true, index: 44}
              entry:
                index: 45
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceUSCoreObservationResults:
                      match: {}
                      schema:
                        isModifier: false
                        refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab']
                        type: Reference
                        mustSupport: true
                        index: 46
                        extensions:
                          sliceTriggerUSCoreObservationResults: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', type: Extension, short: eICR Trigger Code Flag, mustSupport: true, index: 48}
                        elements:
                          extension:
                            index: 47
                            slicing:
                              rules: open
                              discriminator:
                              - {path: url, type: value}
                              min: null
                              slices:
                                sliceTriggerUSCoreObservationResults:
                                  match: {url: null}
                                  schema: {type: Extension, short: eICR Trigger Code Flag, mustSupport: true, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', index: 48}
            required: [text, code]
        slicePlanOfTreatmentSection:
          match:
            code:
              coding:
              - {code: 18776-5, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Plan of Treatment Section
            mustSupport: true
            _required: true
            index: 49
            elements:
              code:
                short: Plan of Treatment
                isModifier: false
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 18776-5, system: 'http://loinc.org'}
                index: 50
              text: {mustSupport: true, index: 51}
              entry:
                mustSupport: true
                index: 52
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceEICRServiceRequest:
                      match: {}
                      schema:
                        isModifier: false
                        short: eICR Service Request entry
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-servicerequest']
                        type: Reference
                        mustSupport: true
                        index: 53
                        extensions:
                          sliceTriggerEICRServiceRequest: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', max: 1, type: Extension, short: eICR Trigger Code Flag, mustSupport: true, index: 55}
                        elements:
                          extension:
                            index: 54
                            slicing:
                              rules: open
                              discriminator:
                              - {path: url, type: value}
                              min: null
                              slices:
                                sliceTriggerEICRServiceRequest:
                                  match: {url: null}
                                  schema: {type: Extension, short: eICR Trigger Code Flag, mustSupport: true, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', index: 55}
                                  max: 1
                    sliceUSCoreMedicationRequest:
                      match: {}
                      schema:
                        isModifier: false
                        short: US Core Medication Request entry
                        refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest']
                        type: Reference
                        mustSupport: true
                        index: 56
                        extensions:
                          sliceTriggerUSCoreMedicationRequest: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', max: 1, type: Extension, short: eICR Trigger Code Flag, mustSupport: true, index: 58}
                        elements:
                          extension:
                            index: 57
                            slicing:
                              rules: open
                              discriminator:
                              - {path: url, type: value}
                              min: null
                              slices:
                                sliceTriggerUSCoreMedicationRequest:
                                  match: {url: null}
                                  schema: {type: Extension, short: eICR Trigger Code Flag, mustSupport: true, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', index: 58}
                                  max: 1
            required: [text, code]
        sliceSocialHistorySection:
          match:
            code:
              coding:
              - {code: 29762-2, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Social History Section
            mustSupport: true
            _required: true
            index: 71
            elements:
              code:
                isModifier: false
                short: Social History Section code
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 29762-2, system: 'http://loinc.org'}
                index: 72
              text: {short: Social History Section narrative, mustSupport: true, index: 73}
              entry:
                mustSupport: true
                index: 74
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceCharacteristicsOfHomeEnvironment:
                      match: {}
                      schema:
                        type: Reference
                        short: Characteristics of Home Environment
                        mustSupport: true
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/characteristics-of-home-environment']
                        index: 75
                    sliceODHPastOrPresentJob:
                      match: {}
                      schema:
                        type: Reference
                        short: ODH Past or Present Job entry
                        refers: ['http://hl7.org/fhir/us/odh/StructureDefinition/odh-PastOrPresentJob']
                        index: 76
                    sliceODHUsualWork:
                      match: {}
                      schema:
                        type: Reference
                        short: ODH Usual Work entry
                        refers: ['http://hl7.org/fhir/us/odh/StructureDefinition/odh-UsualWork']
                        index: 77
                    sliceTravelHistory:
                      match: {}
                      schema:
                        isModifier: false
                        short: ODH Travel History entry
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/travel-history-observation']
                        type: Reference
                        mustSupport: true
                        index: 78
            required: [text, code]
        sliceProblemSection:
          match:
            code:
              coding:
              - {code: 11450-4, system: 'http://loinc.org'}
          schema:
            isModifier: false
            short: Problem Section
            mustSupport: true
            _required: true
            index: 28
            elements:
              code:
                isModifier: false
                short: Problem Section code
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11450-4, system: 'http://loinc.org'}
                index: 29
              text: {short: Problem Section narrative, mustSupport: true, index: 30}
              entry:
                mustSupport: true
                index: 31
                slicing:
                  rules: open
                  discriminator:
                  - {path: resolve(), type: profile}
                  min: null
                  slices:
                    sliceEICRCondition:
                      match: {}
                      schema:
                        isModifier: false
                        short: eICR Condition entry
                        refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-condition']
                        type: Reference
                        mustSupport: true
                        index: 32
                        extensions:
                          sliceTriggerCondition: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', max: 1, short: eICR Trigger Code Flag, type: Extension, mustSupport: true, index: 34}
                        elements:
                          extension:
                            index: 33
                            slicing:
                              rules: open
                              discriminator:
                              - {path: url, type: value}
                              min: null
                              slices:
                                sliceTriggerCondition:
                                  match: {url: null}
                                  schema: {short: eICR Trigger Code Flag, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension', index: 34}
                                  max: 1
            required: [text, code]
  type:
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 55751-2, system: 'http://loinc.org'}
    index: 5
  author:
    isModifier: false
    refers: ['http://hl7.org/fhir/StructureDefinition/Device', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner', 'http://hl7.org/fhir/us/ecr/StructureDefinition/ecr-organization', 'http://hl7.org/fhir/us/ecr/StructureDefinition/ecr-practitionerrole']
    type: Reference
    mustSupport: true
    array: true
    index: 10
  extension:
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: url, type: value}
      min: null
      slices:
        sliceExtensionVersionNumber:
          match: {url: null}
          schema: {short: eICR Composition versionNumber, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber', index: 1}
          min: 1
          max: 1
        extensionEICRInitiationType:
          match: {url: null}
          schema: {short: Initial Case Report Initiation Type, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-type-extension', index: 2}
          min: 0
          max: 1
        extensionEICRInitiationReason:
          match: {url: null}
          schema: {short: Initial Case Report Initiation Reason, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-reason-extension', index: 3}
          min: 0
  identifier: {short: eICR Composition identifier, mustSupport: true, index: 4}
  relatesTo:
    mustSupport: true
    index: 11
    slicing:
      rules: open
      discriminator:
      - {path: code, type: value}
      min: null
      slices:
        sliceTransformed:
          match: {code: transforms}
          schema:
            short: Document or Composition that this Composition is transformed from
            index: 12
            elements:
              code:
                pattern: {type: Code, value: transforms}
                index: 13
              target:
                short: Identifier of the Document or Composition transformed
                choices: [targetIdentifier]
                index: 15
              targetIdentifier: {type: Identifier, short: Identifier of the Document or Composition transformed, choiceOf: target, index: 16}
        sliceReplaced:
          match: {code: replaces}
          schema:
            short: Document or Composition that this Composition replaces
            index: 17
            elements:
              code:
                pattern: {type: Code, value: replaces}
                index: 18
              target:
                short: Identifier/Reference to the Document or Composition transformed
                choices: []
                index: 20
  subject:
    type: Reference
    short: Patient
    isModifier: false
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/ecr/StructureDefinition/ecr-patient']
    index: 7
package_version: 1.0.0
extensions:
  sliceExtensionVersionNumber: {url: 'http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber', min: 1, max: 1, short: eICR Composition versionNumber, type: Extension, mustSupport: true, index: 1}
  extensionEICRInitiationType: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-type-extension', min: 0, max: 1, short: Initial Case Report Initiation Type, type: Extension, mustSupport: true, index: 2}
  extensionEICRInitiationReason: {url: 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-reason-extension', min: 0, short: Initial Case Report Initiation Reason, type: Extension, mustSupport: true, index: 3}
class: profile
kind: resource
url: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition
base: http://hl7.org/fhir/StructureDefinition/Composition
version: 1.0.0
required: [encounter, identifier]